経皮的レーザー椎間板減圧術 (PLDD) 後の手術例の検討

抄録

Between 1996 and 1999, eleven males underwent salvaged operation after Percutaneous Laser Disc Decompression (PLDD) at other hospitals. Their age ranged from 28 to 92 years old (mean: 56.6 years) and follow-up period from 1 month to 37 months (mean: 19 months). PLDD was performed on the cervical spine in 4 cases and lumbar spine in 7 cases. The numbar of PLDDs ranged from 1 to 8 times (mean: 3.3). At the time of salvaged operation, our diagnosis was lumbar herniated intervertebral disc (LHID) in 4 cases, cervical pyogenic discitis (CPD) in 2, and indivisual cases of cervical spondylotic myelopathy (CSM), cervical ossification of the posterior longitudinal ligament (OPLL), lumbar canal stenosis (LCS), lumbar discopathy, and lumbar extradural abscess (LEA).
Salvaged operations were posterior discectomy in 4 cases of LHID, anterior decompression and fusion in 2 cases of CPD and OPLL, laminoplasty for CSM, PILF for LCS, PL-F for lumbar discopathy and laminectomy and debridement for LEA in one each.
The snspected causes for requiring salvaged operations were no improvement after PLDD with appropriate indication in 4 patients, no improvement with inappropriate indication in 3, infection in 3, and in one case the cause was unknown.