Neurological Surgery 脳神経外科39巻9号

2011年09月発行

連載 先天奇形シリーズ

（10）脊髄脂肪腫

著者： 師田信人¹ 荻原英樹¹ 上甲眞宏¹

所属機関： ¹国立成育医療研究センター脳神経外科

ページ範囲：P.897 - P.917

Ⅰ．はじめに

　脊髄脂肪腫は潜在性二分脊椎の代表的疾患である．小児神経外科領域においてしばしば遭遇する疾患であり，多くは出生後早期に診断され，乳児期に初回治療を受ける．発生頻度は出生4,000名あたり1名といわれるが，潜在性であるがゆえに正確な実態は不明である^1,6,49)．外科治療が原則となるが，術後は排尿管理・整形外科的病変・脊髄係留症候群などに対する長期かつ専門的な経過観察が必要となる．その一方で，乳児期に診断されず，年長児あるいは青少年期になり発症することもある．そのため，小児神経外科専門医だけでなく，一般脳神経外科医にとっても基本的な疾患概念の理解，診断・治療の進め方を理解しておくことは重要である．

　ここでは，最も代表的な腰仙部脊髄脂肪腫（脊髄円錐部脂肪腫，脊髄終糸脂肪腫）を中心に，稀な病態である脊髄軟膜下脂肪腫にも触れながら，脊髄脂肪腫の発生・診断・手術および予後について述べる．

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