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日本整形外科学会腰痛評価質問票(JOABPEQ)を用いて慢性椎間板性腰痛患者19例に対する手術成績を評価した.画像診断に加え,整形外科患者に対する精神医学的問題評価のための簡易質問票(BS-POP)を用いて厳密に適応を考慮し固定術を行った結果,JOABPEQ各項目の有効率は,疼痛関連障害100%,腰椎機能障害74%,歩行機能障害68%,社会生活障害63%,心理的障害58%であり,術前の心理的障害の程度により治療効果に差はみられなかった.慢性腰痛においても手術による治療効果が期待できる可能性が示唆されたが,保存治療との比較を行うなどエビデンスレベルの高い検討が今後必要と考えられた.
The results of surgery for chronic discogenic low back pain (CDLP) in nineteen patients were evaluated using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). The indications for surgery were based on clinical and radiological analysis, as well as the Brief Scale for Psychological Problems in Orthopaedic Patients (BS-POP). Posterior lumbar interbody fusion resulted in favorable improvements in all JOABPEQ functional domains. There were no significant differences in the improvement according to the degree of mental disorder. The strict selection of surgical candidates may result in a possible surgical benefit in patients with CDLP. However, stronger study design, such as a case-controlled study with a large sample size, will be needed.
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