臨床整形外科43巻9号

2008年09月発行

論述

上位頚椎インストゥルメンテーション手術における椎骨動脈の骨外・骨内走行の術前評価―3次元CT血管造影法の有用性

著者： 山崎正志¹ 大河昭彦¹ 国府田正雄¹ 高橋和久¹ 梁川範幸²

所属機関： ¹千葉大学大学院医学研究院整形外科学 ²千葉大学医学部附属病院放射線部

ページ範囲：P.875 - P.881

　上位頚椎インストゥルメンテーション手術例77例に対し，術前に3次元CT血管造影法（3D-CTA）を施行し，椎骨動脈の骨外・骨内走行を評価した．骨外走行では，椎骨動脈が環椎後弓の尾側から脊柱管内に侵入する異常が10例（13.0％）に存在した．骨内走行では，high-riding vertebral artery（VA）を21例（27.3％）で確認した．歯突起骨などの骨奇形を伴う例では高頻度に椎骨動脈の骨外・骨内走行異常が存在した．3D-CTAの所見から術中の椎骨動脈損傷の危険性を事前に把握することが可能であり，手術プランニングを的確に行うことができた．結果として術中の椎骨動脈損傷は1例もなく，3D-CTAの有用性が示された．

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