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腰椎椎間板ヘルニアに対する経皮的椎間板摘出術 : 術後成績に関与する因子について
https://doi.org/10.11501/3087633
https://doi.org/10.11501/30876332dd0050c-f3eb-48fb-b6e2-7183132d09d3
| 名前 / ファイル | ライセンス | アクション |
|---|---|---|
000000248098.pdf (7.7 MB)
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| Item type | 学位論文 / Thesis or Dissertation(1) | |||||
|---|---|---|---|---|---|---|
| 公開日 | 2015-05-12 | |||||
| タイトル | ||||||
| タイトル | 腰椎椎間板ヘルニアに対する経皮的椎間板摘出術 : 術後成績に関与する因子について | |||||
| タイトル言語 | ja | |||||
| タイトル | ||||||
| タイトル | Percutaneous discectomy for lumbar disc herniation : Factors that may affect the clinical results | |||||
| タイトル言語 | en | |||||
| タイトル | ||||||
| タイトル | ヨウツイ ツイカンバン ヘルニア ニ タイスル ケイヒテキ ツイカンバン テキシュツジュツ : ジュツゴ セイセキ ニ カンヨ スル インシ ニツイテ | |||||
| タイトル言語 | ja-Kana | |||||
| 著者 |
増田, 明敏
× 増田, 明敏 |
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| 言語 | ||||||
| 言語 | jpn | |||||
| キーワード | ||||||
| 主題言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | Lumbar disc herniation | |||||
| キーワード | ||||||
| 主題言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | Magnetic Resonance Imaging | |||||
| キーワード | ||||||
| 主題言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | Percutaneous discectomy | |||||
| 資源タイプ | ||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_46ec | |||||
| 資源タイプ | thesis | |||||
| ID登録 | ||||||
| ID登録 | 10.11501/3087633 | |||||
| ID登録タイプ | JaLC | |||||
| 要約 | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | The traditional surgical treatment for lumbar disc herniation has been discectomy by the posterior approach. However, postoperative complications such as delayed vertebral instability, epidural fibrosis and adhesive myelomeningitis sometimes occur in a few cases making the sugical result less disirable. Recently, instead of the conventional surgery of discectomy, a new method of percutaneous discectomy has been employed with excellent results. This procedure is simple, safe and only slightly invasive since it causes no direct damage to the dura or nerve roots. For this technique, we developed a nucleotome probe with a rotating electric shaver (3mm in diameter). In this study, the therapeutic results of this procedure and factors that may affect the results were evaluated. The subjects were 119 patients (124 discs) with disc herniation who had not been relieved of sciatica in spite of conservative treatments. They consisted of 79 males and 40 females aged 12-66 years (mean, 31.6 years) and were followed up for 2-13 months (mean, 6.1 months) after operation. The intervertebral levels involved were T12-L1, L1-L2, and L2-L3 in 1 each, L3-L4 in 9, L4-L5 in 63, and L5-S1 in 49. The postoperative results were evaluated according to Macnab's criteria, and the treatment was considered to have been effective when the evaluation was "excellent" or "good". The results were "excellent" in 38, "good" in 56, "fair" in 10, and "poor" in 13, with a percent efficacy of 79.8%. The symptoms were alleviated during or immediately after operation in some patients but more often reduced or resolved about 1 week after operation. No particular postoperative complications were noted. Among the sex, age, level of the affected disc, herniation type, degree of disc degeneration, pain reproducibility during discography, amount of the disc resected, duration of illness, and preoperative severity, which were evaluated as possible factors affecting the operative results, the degree of disc degeneration, level of the affected disc, and herniation type are considered to have some effects on the operative results. The results were less satisfactory when disc degeneration was severe than absent or mild, when the level of the lesion was L5-S1 than L3-L4 or L4-L5, and when herniation was the extrusion type than the protrusion or prolapse type. In 57 patients who were available for preoperative and postoperative MRI, the degree of disc protrusion was reduced postoperatively in 54%, the reduction being 2 mm or more in 8, 0-2mm in 23, but none in 28. The treatment was effective in all 8 patients in whom protruded disc was reduced by 2mm or more. From these results, reduction of the protruded disc would effect the direct decompression of the nerve root and relieve pain. | |||||
| 内容記述言語 | en | |||||
| 要約 | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | 医歯学総合研究科博士論文(医学) ; 学位取得日: 平成3年11月6日 | |||||
| 内容記述言語 | ja | |||||
| 収録雑誌名 |
ja : 鹿児島大学医学雑誌 en : Medical journal of Kagoshima University 巻 43, 号 1, p. 55-64, 発行日 1991 |
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| 作成日 | ||||||
| 日付 | 1991-11-06 | |||||
| 日付タイプ | Issued | |||||
| ISSN | ||||||
| 収録物識別子タイプ | PISSN | |||||
| ISSN | 0368-5063 | |||||
| NII書誌ID（雑誌） | ||||||
| 収録物識別子タイプ | NCID | |||||
| NC ID | AN00040104 | |||||
| 出版タイプ | ||||||
| 出版タイプ | VoR | |||||
| 出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
| NDC | ||||||
| 主題Scheme | NDC | |||||
| 主題 | 494 | |||||
| 公開者・出版者 | ||||||
| 出版者 | 鹿児島大学 | |||||
| 出版者言語 | ja | |||||
| 公開者・出版者 | ||||||
| 出版者 | カゴシマ ダイガク | |||||
| 出版者言語 | ja-Kana | |||||
| 公開者・出版者 | ||||||
| 出版者 | Kagoshima University | |||||
| 出版者言語 | en | |||||
| 関連（relation）（relationType設定なし） | ||||||
| 識別子タイプ | URI | |||||
| 関連識別子 | http://id.ndl.go.jp/bib/000000248098 | |||||
| 関連（isVersionOf） | ||||||
| 関連タイプ | isVersionOf | |||||
| 識別子タイプ | URI | |||||
| 関連識別子 | http://dl.ndl.go.jp/info:ndljp/pid/3087633 | |||||
| 備考 | ||||||
| 備考 | 指導教員: 酒匂崇 ; 平成22年度に行われた国立国会図書館の学位論文（博士）デジタル化事業に際し、著者から、学位授与大学において、国立国会図書館から譲渡を受けた学位論文のデジタル化複製物を利用（全文複写提供、公衆送信）に供することの許諾を受けたものです（参考：http://www.ndl.go.jp/jp/aboutus/digitization_theses.html）。 | |||||
| 学位記番号 | ||||||
| 学位記番号 | 医論第903号 | |||||
| 学位授与年月日 | ||||||
| 学位授与年月日 | 1991-11-06 | |||||
