臨床整形外科50巻7号

2015年07月発行

論述

頚椎椎弓形成術後の後弯化と椎弓再閉鎖の危険因子—頚椎矢状面バランスに着目して

著者： 坂井顕一郎¹ 前原秀二¹ 新井嘉容¹ 相馬真¹ 鳥越一郎¹ 友利正樹¹ 平井高志¹ 佐藤浩一¹ 大川淳²

所属機関： ¹済生会川口総合病院整形外科 ²東京医科歯科大学整形外科

ページ範囲：P.621 - P.628

　背景：頚椎矢状面バランスに注目し，椎弓形成術後の後弯化・椎弓再閉鎖との関連を検討した．

　対象と方法：術前後弯を伴わない頚椎症性脊髄症に対し椎弓形成術を行った157例の術前・術後1年時単純X線像でcervical sagittal vertical axis(SVA)，C2-7前弯角，C7椎体傾斜角，C2-7可動域を計測し，術後後弯化の危険因子を調べた．また，このうち術直後・1年時にMRI撮影が行われていた92例の椎弓開大角を計測し，椎弓再閉鎖との関連も併せて調査した．

　結果：後弯化は157例中8例(5.1％)に認め，年齢とcervical SVAが術前危険因子であった．椎弓再閉鎖は92例中4例(4.3％)に認め，全例が後弯化例であった．

　まとめ：矢状面バランス不全は年齢とともに術後後弯化の術前危険因子であり，後弯化と椎弓再閉鎖に関連を認めた．

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