ミタニ　シゲル   Shigeru Mitani   三谷　茂    所属   川崎医科大学  医学部 臨床医学　脊椎・関節整形外科学    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Minimally Invasive Trans-sacral Canal Plasty for Lumbar Canal Stenosis.
掲載誌名	正式名：Cureus 略　 称：Cureus ISSNコード：21688184/21688184
掲載区分	国外
巻・号・頁	16(5),pp.e59509
著者・共著者	Seiya Watanabe, Kazuo Nakanishi, Ryo Sato, Yoshihisa Sugimoto, Shigeru Mitani
担当区分	最終著者
発行年月	2024/05/02
概要	Objective The elderly population is increasing in Japan. Along with the increase in the elderly population, the number of patients with lumbar degenerative diseases is also on the rise. In general, elderly patients tend to have more complications and are at higher risk for surgery. Many elderly people suffer from lumbar degenerative disease. We reviewed our initial experience with trans-sacral canal plasty (TSCP) for patients with lumbar spinal canal stenosis and examined the pertinent literature for this report. Methods An analytical observational study was performed on 120 patients with lumbar spinal canal stenosis who underwent TSCP at our single institution from March 2019 to October 2021. These patients had leg pain and/or lower back pain due to degenerative lumbar disease. Patients who had coagulation abnormality, pregnancy, contrast allergy, pyogenic spondylitis, or spinal metastasis were excluded. Results Immediately after TSCP, the average Visual Analog Scale (VAS) score for back pain improved from 58.2 to 29.3, and for leg pain from 72.0 to 31.3. Two years after TSCP, the average VAS score for back pain increased slightly and the average score for leg pain remained almost the same. Additional surgery was performed in 37 of 120 (31%) patients who underwent TSCP. The additional surgery group had significantly worse back pain at one and three months postoperatively than the conservative treatment group. The additional surgery group had significantly worse leg pain immediately after TSCP and at one and three months postoperatively than the conservative treatment group. Logistic regression analysis demonstrated that a decreased spinal canal area (OR 0.986, p = 0.039) was associated with additional surgery. Conclusions We reviewed the outcomes of TSCP at our hospital. The average VAS score for back pain and leg pain improved. However, 31% of patients who underwent TSCP required additional surgery. It was found that the spinal canal area was a major factor in the
DOI	10.7759/cureus.59509
PMID	38832205