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요부 외측구역 협착증에서 단순감압술과 기구고정술을 병행한 요추체간 골유합술과의 임상적 비교
손병길,최은석,정을수,신종현,김명진,지용철 대한척추신경외과학회 2004 Neurospine Vol.1 No.1
Objective: The lumbar spinal canal can be devided into the central zone and the lateral zone. The divisions of the lateral zone are the subarticular, the foraminal, and the extraforaminal zone. A common causes of the operation for the spinal stenosis are related to the association with the spondylolisthesis and the central stenosis. There is a paucity of data, however, regarding the operative intervention in the lateral zone stenosis(LZS). Our aim was to analyze the surgical result by the anatomical type and the operative method. Methods: 72 patients of LZS excepting the association with the spondyolisthesis have been operated by six neurosurgeons of our hospital from 30th April, 1994 through 30th September, 2002. The patients had been interviewed about surgical result through telephone by third party persons. The surgical results were analyzed by the four score rating system: ① medication, ② ADL(Ability of daily living), ③ the degree of improvement, ④ the degree of satisfaction. Results: Among 72 patients, there were 25 males and 47 females. The age group of the patients were in their thirties(1), forties(9), fifties(21), sixties(36) and seventies(5). Surgical methods were used on decompression(22), posterior lumbar interbody fusion(PLIF) with cage(1) and PLIF with transpedicular screw fixation system(49). The types of stenosis were subarticular(24), foraminal(16) and extraforaminal(30) and double crush(2). The overall surgical results were Excellent(18), Good(34), Fair(19), and Poor(1). The Non-success rate according to the methods of surgery were decompression(34.8%), PLIF with transpedicular fixation system(24.4%). The overall success rate was(53/72: 73.6%). The success rate according to the types were subarticular(17/24: 70.8%), extraforaminal(21/30: 70%), and foraminal(12/16: 75%). Conclusion: It is suggested that the result was more favorable on the cases of lateral zone stenosis operated with PLIF and transpedicular fixation system. According to the method used, the success rate of decompression was worse than PLIF with transpedicular fixation system.