腰椎外側型病変の病態に応じた治療戦略の工夫

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  • Strategy for Far Lateral Lumbar Disc Herniation and Foraminal Stenosis

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<p>  Lumbar radiculopathy caused by lesions outside the spinal canal, such as far lateral lumbar disc herniation (FLLDH) and lumbar foraminal stenosis (LFS), are not rare conditions. Over the past 6 years, we have treated 5 patients with FLLDH and 8 with LFS. Last year, the incidence of FLLDH and LFS among patients undergoing lumbar surgery patients was approximately 10%. A lateral intermuscular approach was selected as the operative method of choice for all patients with FLLDH and 4 patients with LFS who had no lesions inside the spinal canal. In 2 patients with LFS who had concurrent medial lumbar canal stenosis (MLCS), a paramedian combined approach and decompression of both MLCS and LFS was performed. In 2 patients who had a medical history of laminectomy for MLCS, facetectomy and posterior lumbar interbody fusion (PLIF) with a pedicle screw was performed. In all patients, symptoms completely resolved postoperatively and the post-operative course was uneventful. In conclusion, we would like to stress that accurate diagnosis and adequate surgical treatment will ensure favorable results for patients with FLLDH and LFS.</p>

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  • 脊髄外科

    脊髄外科 25 (2), 170-176, 2011

    日本脊髄外科学会

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