臨床整形外科47巻6号

2012年06月発行

連載 知ってますか？整形外科手術の変遷・3

上位頚椎固定術

著者： 松永俊二¹² 酒匂崇³⁴

所属機関： ¹今給黎総合病院 ²鹿児島大学医学部 ³鹿児島大学 ⁴整形外科酒匂クリニック

ページ範囲：P.592 - P.596

　上位頚椎固定術は，上位頚椎の外傷性疾患，腫瘍性疾患，炎症性疾患(関節リウマチなど)，先天性疾患(歯突起骨など)などによる上位頚椎の不安定性に起因した病態に対して施行されてきた．上位頚椎の不安定性は，頚髄や延髄の圧迫による突然死などの致死的な経過をたどることもある^27,29)ため，上位頚椎の確実な安定性を獲得することが重要である．しかし，当初は手術を行っても安定性の獲得は難しく，その成績も良好ではなかった．その後いろいろな術式が開発され手術成績は向上したが，それぞれの手術に関係した問題点もあることがわかってきた．

　本稿では上位頚椎病変に対する手術の変遷を紹介し術式の特徴について述べる．

参考文献

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