血小板異常による出血傾向症例に対する脊椎内視鏡手術の治療経験

Efficacy of Endoscopic Spinal Surgery for Lumbar Spinal Stenosis in Patients with a Bleeding Tendency Due to a Platelet Disorders

　止血機能異常症例に脊椎手術を施す際には，大量の術中出血を伴う術式選択を避けるともに，十分な局所的止血処置を施し，硬膜外血腫などの術後の合併症発生の予防に努めなければならない．したがって，低侵襲で，十分な局所止血が可能な脊椎内視鏡手術は，この2つの必要条件を満たす優れた治療手段と考える．

　A bleeding tendency in surgical patients can prolong operation time and cause excessive blood loss, and it is associated with a high perioperative complication rate.　Therefore, surgical treatment should be minimized, and adequate hemostasis is essential.　We report two cases of spinal surgery in patients with a bleeding tendency and call attention to the efficacy of using a spinal microendoscope to avoid or minimize intraoperative and postoperative complications.