頚椎黄色靭帯石灰化症の手術例の検討 Clinical Study for Calcification of Ligamentum Flavum of Cervical Spine

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頚椎黄色靭帯石灰化症の手術例について検討した.症例は12(男性2,女性10)例,年齢69.8(54~80)歳で,全例で頚髄症を呈していた.罹病期間は5.7(1~12)か月であった.脊柱管前後径は12.3(10.0~14.0)mmで,椎間板ヘルニアを5例,頚椎すべりを2例,後縦靭帯骨化を1例に認めた.10例は複数の椎間に石灰化が存在しおり,高位はC3/4;6椎間,C4/5;9椎間,C5/6;9椎間,C6/7;8椎間であった.全例に棘突起縦割式脊柱管拡大術を行い,石灰化した黄色靭帯を可及的に切除した.1例に黄色靭帯と硬膜の癒着を認めたが,剥離は比較的容易であった.経過観察期間31.2(6~100)か月で,JOAスコアは術前9.0(5.5~11.0)点から術後13.2(6.0~16.5)点となり,改善率は53.5(-10~91.7)%であった.

We report the mid-term follow-up findings of 12 patients (two males and 10 females) after surgery to treat calcification in the ligamentum flavum (CLF) of the cervical spine. Their mean age was 69.8 (range from 54 to 80) years at operation. Initially, the mean anteroposterior diameter of the spinal canal at the C5 level was 12.3 (10.0-14.0) mm on lateral radiogram. There was combined CLF or other compressive lesions such as disc herniation in five patients, spondylolisthesis in another two, and combined ossification in the posterior longitudinal ligament (OPLL) in another. All patients had objective neural deficits consistent with cervical myelopathy. Each underwent expansive laminoplasty by sagittal splitting of the spinous process. Preoperative calcification was observed at the C3/4 level in six patients, at the C4/5 level in nine, C5/6 in nine, and at the C6/7 in eight. The operative results were evaluated according to the Japanese Orthopaedic Association (JOA) score, after a mean follow-up period of 31.2 (range from six to 100) months. The mean JOA score was 9.0 points before surgery, and was 13.2 points in the most recent follow-up. The overall mean recovery rate by JOA score was 53.5%.

収録刊行物

  • 整形外科と災害外科  

    整形外科と災害外科 55(3), 397-399, 2006-09-25 

    West-Japanese Society of Orthopedics & Traumatology

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各種コード

  • NII論文ID(NAID)
    10018786866
  • NII書誌ID(NCID)
    AN00126582
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    00371033
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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