Neurological Surgery 脳神経外科41巻11号

2013年11月発行

連載 脊椎脊髄手術に必要な基本的知識

（3）頚椎前方手術

著者： 菅原卓¹

所属機関： ¹秋田大学脳神経外科

ページ範囲：P.1023 - P.1034

Ⅰ．はじめに

　頚椎前方手術は頚椎症，椎間板ヘルニア，後縦靱帯骨化症，頚椎頚髄腫瘍，頚髄前面血管病変などの手術として広く行われている．脱出椎間板・骨棘・後縦靱帯骨化巣などの脊髄・神経根圧迫病変は前方にあることが多く，前方アプローチにより病変そのものを処理できることが大きな利点である．また，頚椎前面は後面に比べて付着する筋肉が少量であり，手術による筋層への侵襲が少ない．しかし，多くの前方手術では椎体間固定により椎間板機能が失われること，椎体前面に到達するまでに重要な組織の近傍を通過するために，さまざまな合併症が生じ得ることが欠点である．本稿では手術適応，エビデンス，手術法の概略，合併症とその予防法，インフォームドコンセントについて解説する．

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