臨床整形外科42巻10号

2007年10月発行

誌上シンポジウム 外傷性頚部症候群―最近の進歩

外傷性頚部症候群の症状の解析に関するmultidisciplinary approach

著者： 金岡恒治¹

所属機関： ¹早稲田大学スポーツ科学学術院

ページ範囲：P.965 - P.968

　交通事故による頚椎捻挫受傷者の急性期症状の多くは自然に寛解していくが，約1割は慢性化し，多彩な症状を呈する外傷性頚部症候群（むち打ち症）に移行する．ここでは外傷性頚部症候群の症状について，急性期と慢性期症状に分け，それらの病態を解明するために行われているmultidisciplinary approachについて紹介する．

参考文献

1）Barnsley L, Lord SM, Wallis BJ, et al：The prevalence of chronic cervical zygapophysial joint pain after whiplash. Spine 20：20-25, 1995

2）Borchgrevink GE, Smevik O, Nordby A, et al：MR imaging and radiography of patients with cervical hyperextension-flexion injuries after car accidents. Acta Radiol 36：425-428, 1995

3）Côté P, Cassidy D, Carroll L, et al：A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature. Spine 26：E445-E458, 2001

4）Cusick JF, Pintar FA, Yoganandan N：Whiplash Syndrome kinematic factors influencing pain patterns. Spine 26：1252-1258, 2001

5）遠藤健司：むち打ち損傷ハンドブック．シュプリンガー・フェアクラーク社，東京，2006

6）Eichberger A, Darok M, Steffan H, et al：Pressure measurements in the spinal canal of post-mortem human subjects during rear-end impact and correlation of results to the neck injury criterion. Accid Anal Prev 32：251-260, 2000

7）Friedman D, Flanders A, Thomas C, et al：Vertebral artery injury after acute cervical spine trauma：rate of occurrence as detected by MR angiography and assessment of clinical consequences. AJR Am J Roentgenol 164：443-447, 1995

8）Gimse R, Tjell C, Bjorgen IA, et al：Disturbed eye movements after whiplash due to injuries to the posture control system. J Clin Exp Neuropsychol 18：178-186, 1996

9）Hendriks EJ, Scholten-Peeters GG, van der Windt DA, et al：Prognostic factors for poor recovery in acute whiplash patients. Pain 114：408-416, 2005

10）Inami S, Kaneoka K, Hatashi K, et al：Types of synovial fold in the cervical facet joint. J Orthop Sci 5：475-480, 2000

11）Inami S, Shiga T, Tsujino A, et al：Immunohistochemical demonstration of nerve fibers in the synovial fold of the human cervical facet joint. J Orthop Res 19：593-596, 2001

12）Ito S, Panjabi MM, Ivancic PC, et al：Spinal canal narrowing during simulated whiplash. Spine 29：1330-1339, 2004

13）Kaneoka K, Ono K, Inami S, et al：Motion analysis of cervical vertebrae during whiplash loading. Spine 24：763-770, 1999

14）Lord SM, Barnsley L, Wallis BJ, et al：Percutaneous radio-frequency neurotomy for chronic cervical zygapophyseal-joint pain. N Engl J Med 335：1721-1726, 1996

15）Lord SM, Barnsley L, Wallis BJ, et al：Chronic cervical zygapophysial joint pain after whiplash. A placebo-controlled prevalence study. Spine 21：1737-1744, 1996

16）Nibu K, Cholewicki J, Panjabi MM, et al：Dynamic elongation of the vertebral artery during an in vitro whiplash simulation. Eur Spine J 6：286-289, 1997

17）Ohtori S, Takahashi K, Chiba T, et al：Sensory innervation of the cervical facet joints in rats. Spine 26：147-150, 2001

18）Osti OL, Gun RT, Abraham G, et al：Potential risk factors for prolonged recovery following whiplash injury. Eur Spine J 14：90-94, 2005

19）Pearson AM, Ivancic PC, Ito S, et al：Facet joint kinematics and injury mechanisms during simulated whiplash. Spine 29：390-397, 2004

20）Pettersson K, Hildingsson C, Toolanen G, et al：Disc pathology after whiplash injury. A prospective magnetic resonance imaging and clinical investigation. Spine 22：283-287, 1997

21）Pettersson K, Toolanen G：High-dose methylprednisolone prevents extensive sick leave after whiplash injury. A prospective, randomized, double-blind study. Spine 23：984-989, 1998

22）Radanov BP, Bicik I, Dvorak J, et al：Relation between neuropsychological and neuroimaging findings in patients with late whiplash syndrome. J Neurol Neurosurg Psychiatry 66：485-489, 1999

23）Ronnen HR, de Korte PJ, Brink PR, et al：Acute whiplash injury：is there a role for MR imaging?―a prospective study of 100 patients. Radiology 201：93-96, 1996

24）Rosenfeld M, Gunnarsson R, Borenstein P：Early intervention in whiplash-associated disorders. A comparison of two treatment protocols. Spine 25：1782-1787, 2000

25）Sapir DA, Gorup JM：Radiofrequency medial branch neurotomy in litigant and nonlitigant patients with cervical whiplash. A prospective study. Spine 26：E268-E273, 2001

26）Schrader H, Obelieniene D, Bovim G, et al：Natural evolution of late whiplash syndrome outside the medicolegal context. Lancet 347：1207-1211, 1996

27）Stovner LJ：The nosologic status of whiplash syndrome：a critical review. Spine 21：2735-2746, 1996

28）Suissa S, Harder S, Veilleux M：The relation between initial symptoms and signs and the prognosis of whiplash. Eur Spine J 10：44-49, 2001

29）立原久義，菊地臣一，紺野慎一・他：椎間関節の炎症は神経根障害を惹起するか? ラット腰椎椎間関節炎モデルによる検討．臨整外 41：531-537, 2006

30）Treleaven J, Murison R, Jull G, et al：Is the method of signal analysis and test selection important for measuring standing balance in subjects with persistent whiplash? Gait Posture 21：395-402, 2005