骨形成的偏側椎弓切除術で加療した椎間孔内・外神経根障害例

Abstract

We reviewed the clinical outcome of patients with entrapment radiculopathy at the foraminal and/or extraforaminal lesions, who underwent osteoplastic hemilaminectomy.The patients were eight men, aged 20 to 73 years (mean, 53.6 years), and the mean follow-up time was 7 months (3 to 16 months). The diagnoses were lumbar canal stenosis for 6, combined for 4, post laminectomy for 1, spondylolytic for 1, and lateral lumbar disc herniation for 2. Seven patients reported low back pain, and 8 had sciatica. The nerve roots involved were L4 in 1, and L5 in 7. In all the patients, osteoplastic hemilaminectomy was performed using an absorbable screw made from poly-L-lactic acid for the fixation of the osteotomized lamina.The mean preoperative JOA score of 11.0 was increased to 24.1 at the final follow-up. The recovery ratio was 50% or more for all the patients with a mean value of 73.8%. Two patients gained fusion of the osteotomized lamina, but 6 had not in the short follow-up period.Osteoplastic hemilaminectomy allows appropriate decompression for nerve roots involved under a wide visual field and preservation of posterior structures.