척추관 협착증의 수술적 치료

Other Titles
Surgical Treatment of Spinal Stenosis
Authors
강철형구재모
Department
Dept. of Orthopedic Surgery (정형외과학)
Issue Date
1999
Citation
Keimyung Medical Journal, Vol.18(3) : 387-400, 1999
Abstract
Spinal stenosis is a fairly common low back disorder characterized by the narrowing spinal canal and compression of neural element with resultant leg pain and/or intermittent claudication. The usual cause of the spinal stenosis is the degenerative changes of the spine, so symptoms of this disease get worse as the patients get older. Our surgical indications include: 1) when the patient cannot walk more than 200-300 meters due to neurogenic intermittent claudication and/or 2) when the nerve root palsy is noted. From January 1996 to December 1998, there were 86 cases of spinal stenosis who underwent surgery. Of them, 9 cases were excluded due to loss of follow up or other causes, and 77cases were included in this study, who have been followed more than 6 months after surgery. Method of operation at first half of the series was bilateral laminotomy and medial facetectomy in most cases. But low back pain with buttock, thigh pain due to facet joint syndrome was common residual symptoms, so I added the procedure of posterior instrumentation and lateral fusion for decompression. We had analyzed symptoms and results of operation according to Kirkaldy-Willis' criteria. Of the 77 cases, results were graded as excellent or good in 69 cases(88.3%), and fair or poor in 9 cases(11.7%). The result of decompression with instrumentation and fusion was better (91.7% Excellent or Good results) than that of decompression procedure only (82.8% Good or Excellent results). The problem in fusion group was the bone graft site pain. But this pain was self-limited in most cases or was controllable by medication or local steroid injection in some cases. Fusion was achieved in 72.7% of cases, which was interpreted by simple X-ray.
Keywords
Spinal StenosisDecompressionLaminotomyMedial FacetectomyLa-lateral fusion
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/15158
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학)
2. Keimyung Medical Journal (계명의대 학술지) > 1999
Keimyung Author(s)
강철형
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