戻る 第36回臨床整形外科学会

"Introduction Patients with severe impingement lesion of L-spine, esp. in the group of elderly and post-surgically facing a great challenge in their treatment; The compression over neural structures, superimposed with complicated medical conditions made the surgical result unpredictably; One hundred and five cases were using non-invasive methods, including both extracorporeal shock wave therapy (ESWT) and epidural steroid injection (ESIc); We presented this result. Materials and Methods Every patients with back problems will be categorized into three groups; All of them will be examined physically and roentgenographically, back education, a proper back orthosis, physical therapy and some NSAID will be given in PRN-basis; Cases with condition stabilized in this period will be classified group 1; The other cases treated with ESWT then were classified II ; The remaining cases, group III means failed to have good response to above procedures will be suggested to receive ESIc. From 2015 to 2022, 105 cases performed both ESWT and ESIc with follow-up from six months to five years were collected in this study, Male 33 cases and female 72 cases, age range from forty-three to ninety-two years-old with average eighty-three years old; Presence of stenotic change in spinal canal pathophysiologically found in almost every our cases (98.1%), stenosis associated spondylolisthesis 23.2%, stenosis in post-surgical group 40.4%; After regular follow-up 90.8% obtained satisfactory result, 8.1% had fair result and only 1.1% failed the stagely procedure. Results Cases with a degenerative spine even in severe neural impingement obtained satisfactory result; Detailed study of nature of lesion and proper back education is essential; Without proper education and continuous back care, every effect will be limited and only temporarily! "