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<title>腰椎分離症のミカタ | 株式会社文光堂</title>


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<meta name="description" content="腰椎分離症は，同じように診断をし，同じように治療をしても，治る患者・治らない患者がおり，治療に難渋することも多い疾患とされる．本書は，長年にわたり腰椎分離症に向き合い続けた筆者らがこれまで疑問に感じてきたこと，実際に経験したこと，現在までに判っていること，今後取り組むべき課題などを豊富な図表で解説．タイトルの“ミカタ”は，本疾患を扱う医療従事者にとっては，“診かた” “視かた” “看かた”という意">

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		<h1 class="catchCopy">腰椎分離症の治療・予防に挑む全ての人たちの羅針盤</h1>
		

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					著：酒井紀典（徳島大学大学院医歯薬学研究部運動機能外科学准教授）
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					監修：西良浩一（徳島大学大学院医歯薬学研究部運動機能外科学教授）
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				<ul class="property"><li class="disc">A5判・100頁・2色刷</li><li class="disc">ISBN&nbsp;978-4-8306-2739-2</li><li class="disc">2019年5月1日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">腰椎分離症は，同じように診断をし，同じように治療をしても，治る患者・治らない患者がおり，治療に難渋することも多い疾患とされる．本書は，長年にわたり腰椎分離症に向き合い続けた筆者らがこれまで疑問に感じてきたこと，実際に経験したこと，現在までに判っていること，今後取り組むべき課題などを豊富な図表で解説．タイトルの“ミカタ”は，本疾患を扱う医療従事者にとっては，“診かた” “視かた” “看かた”という意味であり，未来ある子供（患者さん）たちにとって，“味方”になりたい，そう願ってつけられている．</section><section class="preface">はじめに<br><br>　筆者は医師免許を取得し，すぐに徳島大学整形外科学教室に入局したこともあり，腰椎分離症は昔から馴染みの深い疾患でした．当初から“子供の疲労骨折”の1つと認識はしていましたが，徐々に経験を重ねていくうちに，その治療は一筋縄ではいかないことがわかってきました．同じように診断をして，同じように治療をしても，治る患者・治らない患者がいる．なぜなのか？<br>　つらい経験もしてきました．すごく奥深い病態をもつ疾患であることもわかってきました．臨床の現場で疑問が浮かぶたびに，師匠であり兄のような存在である西良浩一先生に相談しながら，解決しようと努めてきました．<br>　2017年の日本脊椎脊髄病学会で，“1センチにも満たない骨欠損部へのこだわり”という副題をつけて講演をさせていただきましたが，1センチにも満たない重箱の隅でも，10年以上研究を続けていますと，こんな筆者でも講演や診察・手術などに呼んでいただけるようになりました．<br>　あちこちで講演や診療をさせていただきますと，まだまだ解決すべき課題があることや，全国に困っている子供たちがたくさんいることを，思い知らされるようになりました．<br>　本書は，腰椎分離症に関して，これまで筆者が疑問に感じてきたことや，実際に経験したこと，現在（2018年の冬）までにわかっていること，今後取り組むべき課題などについて，思うがまま書きつづりました．<br>　本書のタイトルには“ミカタ”という言葉を使いました．腰椎分離症を扱う医療従事者の方々のためには，“診かた” “視かた” “看かた”という意味でありますが，未来ある子供（患者さん）たちにとって，“味方”になりたい，そう願ってタイトルをつけました．本書を手にとっていただいた皆様に少しでもお役に立てることを祈ります．<br><br>　令和元年5月<br>　酒井紀典</section><section class="indexes">I　病態<br>　Q1　分離症ってなに？<br>　Q2　分離症の患者ってどのくらいいるの？<br>　Q3　分離症っていつ発生するの？<br>　Q4　分離症は遺伝するの？<br>　Q5　分離症になるとみんな痛いの？<br>II　診断<br>　Q1　分離症の症状は？<br>　Q2　分離症患者の身体所見は？<br>　Q3　分離症をどうやって診断するの？（単純X線写真）<br>　Q4　分離症をどうやって診断するの？（CT）<br>　Q5　分離症をどうやって診断するの？（MRI）<br>III　保存治療<br>　Q1　分離症の治療方針は？<br>　Q2　分離症は治るの？<br>　Q3　分離症をどうやって治すの？（骨癒合目的）<br>　Q4　分離症の治りやすい，治りにくいってあるの？（脊椎高位の話）<br>　Q5　分離症をどうやって治すの？（疼痛管理）<br>　Q6　分離症をどうやって治すの？（リハビリテーション）<br>　Q7　分離症完成後，すべるの？すべらないの？（予後）<br>IV　手術治療<br>　Q1　分離症の手術治療の適応は？<br>　Q2　分離症の手術方法は？（分離部修復術の歴史）<br>　Q3　分離症の手術方法は？（低侵襲治療）<br>　Q4　分離すべりになってしまった場合の手術方法は？<br>V　リハビリテーション<br>　Q1　分離症のリハビリテーションは？<br>　Q2　分離症の治療後のスポーツ復帰はどうする？<br>　Q3　分離症の再発予防はどうする？<br>　Q4　分離症の発生予防はどうする？<br>VI　スポーツ種目と分離症<br>　Q1　分離症とサッカー<br>　Q2　分離症と野球<br>　Q3　分離症と陸上競技<br>VII　非典型例・難治例・類似疾患<br>　Case1　分離症は本当に疲労骨折？<br>　Case2　骨はついてるけど…<br>　Case3　Laminolysis<br>　Case4　初診時，反対側に終末期分離症がみられた症例<br>　Case5　上・下関節突起骨折<br>　Case6　腰椎以外の分離症<br>索　引<br><br>こう考える！<br>　昔の先生方は偉い！<br>　被曝量を減らそう！	<br>　CTによる病期分類<br>　仙骨の疲労骨折も見逃せない！<br>　ホントに分離症？<br>　治療中は，全面スポーツ活動中止？どこまでやっていいの？<br>　治療装具のはなし<br>　腰椎の血行のはなし<br>　すべったらどうなる？<br>　復帰時の装具はどうする？<br>　体幹トレーニングで予防できる？<br>　ポジションと分離症の発生<br>　走り込みとの関連</section></article>
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