脊椎疾患における性格心理的影響

Personality and Psychological Aspects of Spinal Disorders

　抄録：2000年以降当科に手術目的で入院した一連の脊椎疾患患者72例を対象に，術前モーズレイ性格テストおよびSF-36を行った．手術時診断名は脊髄腫瘍20例，脊椎腫瘍7例，脊柱変形8例，頚髄症7例，腰部脊柱管狭窄症6例，脊椎外傷4例，キアリ奇形4例，胸椎靱帯骨化症4例，脊椎カリエス2例，脊髄ヘルニア2例，その他8例である．脊椎疾患では性格的に内向性，虚偽傾向がみられ，脊髄腫瘍病変の患者でテスト陽性例が多い傾向が認められた．SF-36の結果はテスト陽性例では全体にスコアは正常例と比べ低値であり，特に精神面の項目であるSF，MHで有意差を認めた．術後改善率は内向型性格では59.2％，神経症型が25.0％，転嫁順応型が71.8％，精神不安定型が-25.0％であり，テスト陽性例38.9％，正常例71.4％と有意に陽性例で劣っていた．モーズレイ性格テストは術前の患者性格心理的評価として有用と考えられた．

　We administered the Maudsley Personality Inventory (MPI) and SF-36 preoperatively to 72 consecutive spinal disorder patients (33 men and 39 women；mean age, 46.6 years；range, 13 to 80 years) since January 2000. The spinal disoders consisted of spinal cord tumor (20 cases), spinal tumor (7 cases), spinal deformity (8 cases), cervical myelopathy (7 cases), lumbar spinal canal stenosis (6 cases), trauma (4 cases), Chiari malformation (4 cases), thoracic OPLL (4 cases), caries (2 cases), spinal cord herniation (2 cases) and others (8 cases). The spinal disorder patients were inclined to be introverted and prevaricate, and spinal tumor patients tended to be MPI-positive. The SF-36 scores of MPI-positive patients were generally lower than those of MPI-normal patients, and there are significant differences in SF and MH wihch represent mental health component. The postoperative improvement rate was 59.2％ in the introversion type, 25.0％ in neuroticism type, 71.8％ in the adaptive and ongoing type, and-25.0％ in emotional instability type, and there was significant difference between MPI-positive cases (38.9％) and MPI-normal cases (71.4％). The MPI is a useful means of evaluating the preoperative personality and psychological aspects of spinal surgery patient.