脊髄内視鏡の臨床応用

抄録

We have employed small-caliber endoscopes to observe spinal lesions since 1993. This new technique revealed several interesting findings which have been impossible to be observed without this method.
Fifteen patients underwent endoscopy. Representative findings were as follows; rapid to-and-fro movements of the CSF in canal stenosis, hypervascularity of cord and cauda equina in spinal AVM, and deformity of the spinal cord in spinal tumors. In Hirayama disease upward movement of the spinal cord along with the dural canal was prominent especially while the patient flexed the neck anteriorly. In a case with neurinoma, anatomical relationship between the tumor and the root was well visualized and the mass was, though partially, well evaporated by KTP-laser without sequelae.
In conclusion, spinal endoscopy is a safe and efficacious tool to examine the dynamic aspects of spinal pathology. Although KTP-laser has already been applicable to some endoscope, development of equipment proper for spinal endoscopy such as a bipolar coagulator and an irrigation system is still mandatory for achieving surgery safely.