不安定性を有する腰椎変性疾患に対するキョク突起間固定を主とした運動分節固定の治療成績

Abstract

We report on three different types of inter-spinous process fusion (ISPF) thechniques which were used to stabilize the lumbar disc lesions in 144 patients with symptomatic segmental instability.Fourty-four patients received on H-shaped bone graft between the upper and lower interspinous processes of the lesioned disc. Both spinous processes and grafted bone were then fixed by wire (or tetron tape).After 2 or 3 weeks of bed-immobilization, patients were permitted to stand and to walk with a body cast.Movement of the fused segment was recognized by functional X-ray in two patients. Of them, one had reconstructive surgery for pain, at which time it was shown that one of the two grafted bones had abnormal movement, but the others was almost consolidated.To obtain earlier and stronger stabilization, and to reduce the period of bed rest ceramic artificial bone and facet fusion were also carried out in several cases.The improved facet fusion technique was believed to achieve more effective stabilization with the H-graft technique.