外側型腰椎椎間板ヘルニアに対する内外側アプローチの成績

Abstract

We treated 8 cases (5 males and 3 females) with lateral lumbar disc herniation surgically since 1995, and the intralateral approach, in which intralamina fenestration was performed in addition to a paraspinal approach, was conducted in 5 cases. We operated on the cases that had not been efective for conservative treatments, and chose the intralateral approach for the cases that was thought difficult for only medial fenestration. The purpose of this study is evaluate postoperative clinical improvement the in JOA score with procedure.The average age at the time of surgery was 63.4 years (range; 56 to 76 years). The follow-up period averaged 1 year 9 months. The level was L2/3 in 1 case, L3/4 in 1, L4/5 in 3, L5/S1 in 3. Depending on the case intralateral approach, Love's method, or partial laminectomy was conducted without facetectomy.The results were as follows: the mean JOA scores before treatment were 11.8/29 for the intralateral approach (5 cases), 17/29 in Love's method (1 case), 12.5/29 in partial laminectomy (2 cases), and 14/29 for the conservative group. The mean JOA scores after treatments were 24.2/29 for the intralateral approach, 26/29 for the Love's method, 26.0/29 for the partial laminectomy, and 25.4/29 for the conservative group. The mean percentage of clinical improvement was 71.9%, 75%, 82.2%, and 75.6% respectively. All patients evaluated their degree of satisfaction were excellent or good.