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RISS 인기검색어
- 검색키워드
- 저자 : Motohide Shibayama (검색결과 2 건)
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Fujio Ito,Zenya Ito,Motohide Shibayama,Shu Nakamura,Minoru Yamada,Hideki Yoshimatu,Mikinobu Takeuchi,Kenzo Shimizu,Yasushi Miura 대한척추신경외과학회 2019 Neurospine Vol.16 No.1
Objective: Spinal stenosis is increasingly common due to population aging. In elderly patients with lumbar central canal stenosis (LCCS), minimizing muscle damage and bone resection is particularly important. We performed a step-by-step operation with a newly designed spinal endoscope to obtain adequate decompression in patients with spinal stenosis. Methods: From April 2015 to August 2016, 78 patients (48 males, 30 females) with LCCS (91 segments) underwent endoscopic decompression using a newly designed endoscope system. The inclusion criteria were: (1) neurogenic intermittent claudication with or without radiculopathy, (2) LCCS, and (3) having exhausted conservative treatment (>3 months). The exclusion criteria were: (1) >10° of instability, (2) spondylolisthesis grade II or greater according to the Meyerding criteria, (3) foraminal stenosis, (4) vascular intermittent claudication, (5) infection, and (6) stenosis combined with malignancy. We performed a step-by-step procedure using a newly designed endoscope system for unilateral-approach bilateral decompression. We used the same incision for 2–3 segments, only moving the skin. Results: The mean follow-up was 2.3±1.3 years. Excellent or good results were found according to the MacNab criteria in 85.9% of cases (67 of 78). The visual analogue scale, Japanese Orthopedic Association score, and Oswestry Disability Index showed significant decreases at 1 month, persisting until the 2-year follow-up. Dural tear occurred in 4 cases (5.1%), and patch repair was performed under endoscopy. No patients experienced aggravated instability requiring surgery. Conclusion: We obtained good results with endoscopic decompression surgery using a newly designed instrument that minimized muscle and bone damage in elderly patients with spinal stenosis.
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Methods and Early Clinical Results of Percutaneous Lumbar Interbody Fusion
Shu Nakamura,Fjio Ito,Zenya Ito,Motohide Shibayama 대한척추신경외과학회 2020 Neurospine Vol.17 No.4
Objective: Percutaneous lumbar interbody fusion (PELIF) is a procedure that includes the use of new devices, which allow minimally invasive diskectomy under the percutaneous full-endoscopic guidance and safe percutaneous insertion of a standard-sized cage. This procedure can be applied to severe disk degeneration, spondylolisthesis, and all lumbar intervertebral levels including the L5–S1 level. We report the methods and the clinical outcomes of this procedure. Methods: Percutaneous diskectomy was performed with an outer sheath cutter and other devices. A cage was inserted with an L-shaped retract-slider. Hybrid facet screw fixation was performed for severe disk degeneration without spondylolisthesis. Conventional percutaneous pedicle screw fixation was performed for spondylolisthesis. The subjects consisted of 21 patients, who underwent PELIF and were followed up for 1 year or longer. Results: No complications related to cage insertion were detected. The mean visual analogue scale scores were improved from 6.1 to 1.9 for lower back pain in severe disc degeneration cases without spondylolisthesis, and from 7.6 to 1.0 for lower extremity symptoms in spondylolisthesis cases. Conclusion: The clinical outcomes were favorable. PELIF was found to be a minimally invasive method that did not compromise safety and efficiency. PELIF is a possible therapeutic option that should be considered for not only spondylolisthesis at various intervertebral levels but also for severe disk degeneration because of its minimal invasiveness.
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