臨床整形外科51巻10号

2016年10月発行

臨床経験

頚椎椎弓形成術の術後後弯発生と全脊椎矢状面アライメントの関係

著者： 松岡佑嗣¹ 鈴木秀和¹ 遠藤健司¹ 西村浩輔¹ 堀江真司¹ 田中英俊¹ 山本謙吾¹

所属機関： ¹東京医科大学整形外科分野

ページ範囲：P.983 - P.988

背景：片開き式頚椎椎弓形成術(ELAP)術後後弯発生と術前全脊椎アライメントとの関係は不明な点が多い．

対象と方法：術前頚椎後弯のない頚髄症患者でELAPを施行した23例を対象とした．術後後弯群，非後弯群に分類して術前術後の全脊椎アライメントを比較検討した．

結果：後弯群は，C7 plumb lineから仙骨後方隅角までの距離(SVA)は小さく，C2 plumb lineからC7椎体中央までの距離(C-SVA)は大きく，骨盤形態角(PI)が小さいにも関わらず大きな腰椎前弯角(LL)を呈していた．また，後弯群は，術後に第1胸椎傾斜角(T1-slope)と胸椎後弯角(TK)が増大し頚椎は後弯化していた．

まとめ：頚椎後弯発生例では術前SVA，PI-LLが小さく，C-SVAが大きかった．

参考文献

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