著者
小山 なつ 等 誠司
出版者
日本脊髄外科学会
雑誌
脊髄外科 (ISSN:09146024)
巻号頁・発行日
vol.29, no.3, pp.287-292, 2015 (Released:2016-04-01)
参考文献数
12
著者
梶原 基弘 花北 順哉 諏訪 英行 塩川 和彦 佐藤 宰 織田 雅
出版者
日本脊髄外科学会
雑誌
脊髄外科 (ISSN:09146024)
巻号頁・発行日
vol.17, no.1, pp.53-58, 2003

正中型の大きな腰椎椎間板ヘルニアに対するtransdural approachにつき, 経験した4症例を呈示しながら, その利点, 欠点につき論じた.高位腰椎の大きな正中型ヘルニアの症例に対してはtransdural approachは有用な手術オプションになると思われた.
著者
中尾 弥起
出版者
日本脊髄外科学会
雑誌
脊髄外科 (ISSN:09146024)
巻号頁・発行日
vol.30, no.1, pp.83-87, 2016 (Released:2016-07-06)
参考文献数
39

Most patients with significant spinal cord damage have permanent symptoms and may be wheelchair-bound, depending on their residual motor function below the spinal cord lesion. Spinal cord damage, whether caused by injury or disease, is currently not repaired by any therapy. The sensory, motor, and autonomic functions of each segment depend crucially on connections with supraspinal sites for all conscious or voluntary actions. Damage to these connections leaves spinal segments caudal to the lesion site partially or totally isolated from the brain, resulting in debilitating consequences. Studies in humans have demonstrated, however, that the lumbosacral spinal circuitry retains an intrinsic capability to oscillate and generate coordinated rhythmic motor activity even when isolated from brain control. Although the anatomical architecture of locomotor central pattern generators remains poorly understood in mammals, the functional phenomenon of central pattern generation has been documented extensively. Techniques to stimulate spinal networks lend themselves as potent tools to facilitate locomotor recovery after severe spinal cord injury. Among several experimental strategies tested for activation of locomotor circuits in mammals after complete spinal cord transection, electrical stimulation has been investigated in human spinal cord injury. A recent clinical study demonstrated that some patients with complete paralysis were able to perform voluntarily controlled movements with epidural stimulation. In combination with epidural electrical stimulation of lumbosacral segments, activity-based rehabilitation can restore supraspinally mediated movements. Electrical neuromodulation therapies that activate spinal cord central pattern generators open up new avenues for treatment of spinal cord injury in human subjects.
著者
高橋 敏行 冨永 悌二 横堀 寿光 吉本 高志
出版者
日本脊髄外科学会
雑誌
脊髄外科 (ISSN:09146024)
巻号頁・発行日
vol.15, no.1, pp.1-6, 2001
被引用文献数
1 or 0

Cervical interbody fusion cages (CIFC) are currently used for anterior cervical fusion. There are few reports documenting their biomechanical property in the cervical spine. The purpose of the present study is to investigate biomechanical stability of the caprine cervical spine implanted with a CIFC device. Thirty-two spinal units (C3-4 and C5-6) were harvested from 16 fresh-frozen caprine cervical spines. Each spinal unit underwent discectomy and transection of the posterior longitudinal ligament, and then was implanted with single CIFCs, double CIFCs, autograft, or autograft and anterior cervical plate. An iliac crest tricortical bone was used as an autograft. The degrees of displacement of the cervical spine specimens by multidirectional moments in flexion, extension, lateral bending and axial rotation were evaluated using a video-recording. The stiffness against the multidirectional loads was calculated from load-displacement curves. There were no statistical differences in stiffness between the single-cage and autograft groups in flexion, extension and axial rotation. The autograft group showed significantly increased stiffness compared with that of the single-cage group in lateral bending. The stiffness values were far larger in both the double-cage and autogtraft with plating groups than in the other groups in all directions. There were no statistical differences in stiffness between the double-cage and autogtraft with plating groups in flexion, lateral bending and axial rotation. The double-cage group showed significantly decreased stiffness compared with that of the autograft with plating group only in extension. The stiffness values of the single- or double-cage groups would represent the characteristic biomechanical properties derived from the structure and shape of the implants.
著者
村上 正人
出版者
日本脊髄外科学会
雑誌
脊髄外科 (ISSN:09146024)
巻号頁・発行日
vol.30, no.3, pp.260-265, 2016 (Released:2017-01-31)
参考文献数
24
著者
佐藤 純
出版者
日本脊髄外科学会
雑誌
脊髄外科 (ISSN:09146024)
巻号頁・発行日
vol.29, no.2, pp.153-156, 2015 (Released:2016-01-20)
参考文献数
18

慢性痛が天気の崩れで悪化することは以前より知られており, 疼痛治療の臨床において重要な問題である. 筆者は, 気象要素 (気圧, 気温) による慢性痛悪化のメカニズム研究により, 日常体験する程度の軽微な気圧変化あるいは低温への曝露が慢性痛モデル動物の痛み行動を増強し, 慢性痛有訴者の症状を再現することを実証してきた. また, 気圧変化による痛みの増強には内耳の気圧感受メカニズムが関与することを明らかにし, 温度変化による痛みの増強には皮膚の温度受容線維の反応性の変化が原因である可能性を示した. また, 慢性痛有訴者の一部では気圧や気温の変化に対して自律神経系が過剰に反応することがあり, それが症状悪化のもう1つの原因であることを示唆した.
著者
西浦 巖
出版者
日本脊髄外科学会
雑誌
脊髄外科 (ISSN:09146024)
巻号頁・発行日
vol.19, no.3, pp.221-226, 2005 (Released:2006-05-12)
参考文献数
10

341 operated cases of lumbar disc hernia were analyzed. Cases of pure hernia were 87%, those with lumbar canal stenoses were 13%. The average age was 50.3 years-old and the male to female ratio was almost 2 to 1.The indication of surgery should be analyzed first, according to the patient's neurological status, complaints and the duration of leg pain. It also can be determined by examining the evidence of the findings of radiological images of neural compression. However, it may be also indicated, in consideration of the psychiatric aspects, excluding neurological degenerative diseases.In deciding the surgical plan, (whether it is limited to minimum surgery, or extended to the wide laminectomy), the surgeon should consider the following points; whether the patient is of working age or not, and whether his labor is physical work or not, for example.One of the other important points of surgical strategy is to make a change as promptly as possible from minimum laminotomy to the wide laminectomy, when the case of a large size hernia is accompanied with a severely narrow canal. This is in order to protect the nerve root, at the same time, as aiming for the maximum removal of the herniated tissue. Nevertheless, the rate of recurrence could not be decreased more than 2∼3%.The investigation of preoperative risk factors brings a decrease in the percentage of complications, such as, brain or heart vascular disorders, Exceptions would be postoperative infections or hematomas.
著者
中西 欣弥 花北 順哉 川原 功祐 佐藤 宰 織田 雅 梶原 基弘 駒谷 英基
出版者
日本脊髄外科学会
雑誌
脊髄外科 (ISSN:09146024)
巻号頁・発行日
vol.17, no.2, pp.113-118, 2003
参考文献数
14

高位腰椎椎間板ヘルニアの外科的治療は, ヘルニアの突出方向に対応してlateral typeに対してはUPH, mediolateral typeにおいても基本的にはUPH, ただしhuge discの場合はBPHあるいはTLが必要と考えられた.far-lateral typeにおいてはLA, medial typeに対してはTLあるいはTDAによりヘルニア摘出が可能と考えられた.
著者
角家 暁
出版者
日本脊髄外科学会
雑誌
脊髄外科 (ISSN:09146024)
巻号頁・発行日
vol.13, no.1, pp.1-14, 1999

わが国の脳神経外科における脊椎・脊髄外科の歴史を考察した.日本脳神経外科研究会から学会となった1948年から1951年代には脊髄の解剖, 生理についての貴重な発表, 論文が多数存在するが, 今回は脊椎・脊髄の外科の歴史をたどるのが目的であるため除外した.今回の考察は多くの人々から提供された資料と私個人で行った調査を基に記述した.しかし先駆者の重要な貢献を取りこぼしている可能性があるとも考えられ, そのような場合はお詫びするとともに, 補筆したいので是非著者にお知らせいただきたいと願っている。