腰椎椎間板外側ヘルニアの手術成績と合併症

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  • Clinical Results and Postoperative Complications in Patients with Lateral Lumbar Disc Herniation

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Objective: We investigated clinical results and postoperative complications in patients with lateral lumbar disc herniation. Patients and Methods: Between 2005 and 2009, 10 patients underwent surgical treatment for lateral lumbar disc herniaton. The patients comprised 6 males and 4 females with an average age of 62 (45-93) years. The surgical procedures included osteoplastic hemilaminectomy in 4 patients, herniotomy via a postero-lateral approach in 5, and unilateral facetectomy and herniotomy via a postero-lateral approach in one. Surgical outcomes were assessed on the basis of the Japanese Orthopaedic Association score (JOA score), and postoperative complications were investigated. Results: The average JOA score was significantly improved from 9.7 points preoperatively to 20.6 points postoperatively. Postoperative complications included leg pain due to intraoperative neural damage, complex regional pain syndrome (CRPS), peroneal nerve palsy, and subcutaneous hemorrhage in one patient each. The patients with leg pain and CRPS had extraforaminal herniation at the L5/S level, and underwent herniotomy via a posterolateral approach. Conclusions: Surgical outcomes were mostly satisfactory. However, several complications occurred. When lateral lumbar fenestration is performed, it is essential to protect the L5 nerve root from intraoperative injury.

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