ナカニシ　カズオ   Kazuo Nakanishi   中西　一夫    所属   川崎医療福祉大学  リハビリテーション学部 理学療法学科    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	Efficacy of Minimally Invasive Trans-Sacral Canal Plasty between Patients with and without Failed Back Surgery Syndrome.
掲載誌名	正式名：Medicina (Kaunas, Lithuania) 略　 称：Medicina (Kaunas) ISSNコード：16489144/1010660X
掲載区分	国外
巻・号・頁	58(2),pp.251-251
著者・共著者	Funao Haruki, Yokosuka Kimiaki, Ukai Junichi, Nakanishi Kazuo, Paku Masaaki, Tomita Takashi, Hoshino Masahiro, Saito Takanori, Ishii Ken, Sato Koji
発行年月	2022/02
概要	Background and Objectives: Clinicians are required to manage a growing number of elderly patients with several medical comorbidities, and invasive surgical treatments are sometimes not advisable for these patients. The aim of this study was to evaluate the efficacy of minimally invasive intraspinal canal treatment, trans-sacral canal plasty (TSCP), for patients with and without failed back surgery syndrome (FBSS). Materials and Methods: A multicenter analysis was conducted. TSCP was performed in patients with chronic low back pain and leg pain due to lumbar spinal disorders. An adhesiolysis by TSCP was carried out, then a mixture of steroid and local anesthesia was injected. Visual Analog Scales (VAS) for low back pain and leg pain, and complications were evaluated. Results: A total of 271 patients with a minimum 6-month follow-up were enrolled. There were 80 patients who had a history of previous lumbar spinal surgery (F group), and 191 patients without previous lumbar spinal surgery (N group). There were no significant differences in sex and age between the two groups. VAS scores for low back pain (N group/F group) preoperatively, immediately postoperatively, and 1 month, 3 months and 6 months postoperatively, were 51/52 mm, 24/26 mm, 33/34 mm, 30/36 mm, and 30/36 mm, respectively. VAS scores for leg pain were 69/67 mm, 28/27 mm, 39/41 mm, 36/43 mm, and 32/40 mm, respectively. Both VAS scores for low back pain and leg pain were significantly decreased from baseline to final follow-up in both groups (p < 0.01). However, VAS scores for leg pain at 3 months and 6 months postoperatively were significantly higher in F group (p < 0.05). There were three catheter breakages (2/3 in F group), and one dural tear in F group. Conclusions: TSCP significantly reduced both VAS scores for low back and leg pain in patients with and without FBSS. However, co-existence of intractable epidural adhesion might be associated with less improvement in FBSS.
DOI	10.3390/medicina58020251
PMID	35208574