黄色靭帯嚢腫手術例の検討 Surgical Results of Yellow Ligament Cysts of Lumbar Spine

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黄色靭帯嚢腫で臨床症状を呈した5症例(6嚢腫)を報告する.【対象と方法】全例男性,年齢56~87歳(平均61.5歳).全例,摘出後の病理検査にて本症と診断した.術後経過観察期間は3~37ヵ月(平均11.5ヵ月).臨床像と病理所見を検討した.【結果と考察】全例が下肢痛を,4例は間欠跛行を訴えていた.MRI上,嚢腫は片側硬膜の後方に存在し,T2強調像で内部の高輝度域を輪状の低輝度が取り囲む所見であった.3例では準ラブ法により,1例ではSCD(半全周性除圧)により,開窓術後に生じた1例ではen-block laminectomyにより,嚢腫を摘出した.術中所見では嚢腫は黄色靭帯内に存在し,病理検査で線維性嚢腫壁が懐死組織を取り囲む像であった.腰椎スコアは術前平均13点,術後25点,平均改善率は79%であった.摘出後1年で同一椎間の反対側に本症を発症した1例を経験し,術後の経過観察が必要と考えた.

We present five male patients with six yellow ligament cysts (mean age: 61.5 years). All patients complained of leg pain, and four had intermittent claudication. Their mean preoperative lumbar score of the Japanese Orthopaedic Association was 13. MRI revealed that the cyst was located posterior to the dura, and had low intensity in T1-WI and a high-intensity area surrounded by a low-intensity ring in T2-WI. The cyst was resected in all patients. Modified Loves procedure with fenestration was performed in three patients and semicircumferential decompression and en-block laminectomy was performed in each patient because of combined spinal canal stenosis. One patient developed another cyst at the left side after one year of removal of the right cyst. There was an elliptical cyst inside the yellow ligament, and pathological examination revealed necrotic tissue surrounded with a fibrous wall. Postoperative follow-up ranged from 3 to 37 months. Leg pain was relieved in all patients. The lumbar score improved by 25 with a mean improvement of 79%.<BR>Favorable results may be expected after resection and decompression of the yellow ligament cyst of the lumbar spine, however, further follow-up is needed since new cysts may occur at the opposite site.

収録刊行物

  • 整形外科と災害外科  

    整形外科と災害外科 56(2), 246-250, 2007-03-25 

    West-Japanese Society of Orthopedics & Traumatology

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各種コード

  • NII論文ID(NAID)
    10018917109
  • NII書誌ID(NCID)
    AN00126582
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    00371033
  • データ提供元
    CJP書誌  J-STAGE 
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