胸椎椎間板ヘルニアに対する後方経路胸椎椎体間固定術（PTIF）

Posterior Thoracic Interbody Fusion (PTIF) for Thoracic Disc Herniation

　胸椎椎間板ヘルニアに対する後方経路胸椎椎体間固定術(PTIF)の手術成績を明らかにするために，6カ月以上の追跡が可能であった11例・12椎間を調査した．手術時年齢は平均51.3歳，追跡期間は平均47カ月であった．JOAスコア(11点満点)は，術前5.1点が術後8.6点に改善し，改善率は平均57.0％であった．合併症は硬膜損傷を1例，偽関節に伴う局所後弯の進行を1例に認めた．T2/3やT3/4の上位胸椎症例にも手術可能であった．PTIFは胸椎椎間板ヘルニアの手術として有用な方法であると考える．

　The purpose of this study was to investigate the surgical outcomes of posterior thoracic interbody fusion (PTIF) by total facetectomy with pedicle screw fixation for myelopathy due to thoracic disc herniation.　Twelve patients underwent PTIF consecutively between 1999 and 2010, and this study group was comprised of 11 patients who were followed for at least 6 months.　Average age at operation was 51.3 years.　Average follow-up period was 47 months.　The levels of PTIF were thoracolumbar legion in 9 patients, and upper thoracic legion in 2.　Average pre- and postoperative JOA score (maximum 11 points) was 5.1 and 8.6, respectively.　Average recovery rate was 57.0 %.　Postoperative complications consisted of cerebrospinal fluid leakage in 1 patient and progression of local kyphosis due to pseudoarthrosis in 1.　There were neither neurological complications nor adjacent segment degeneration.　PTIF for myelopathy due to thoracic disc herniation can provide satisfactory results.