臨床整形外科52巻12号

2017年12月発行

臨床経験

頚椎後縦靱帯骨化症に対する椎弓形成術術後後弯発生と全脊椎矢状面アライメント

著者： 関健¹ 松岡佑嗣¹ 遠藤健司¹ 鈴木秀和¹ 澤地恭昇¹ 西村浩輔¹ 小島理¹ 松岡恒弘¹ 山本謙吾¹

所属機関： ¹東京医科大学整形外科学分野

ページ範囲：P.1191 - P.1195

背景：頚椎に後弯のない頚椎後縦靱帯骨化症(ossification of the posterior longitudinal ligament：OPLL)に対し，頚椎椎弓形成術(expansive cervical laminoplasty：ELAP)術後頚椎後弯発生の危険因子を検討した．

対象と方法：術前C2-7 SVA(sagittal vertical axis)≦80mm，SVA≦95mmの頚椎OPLL患者27例に対し，術前の頚椎形態と全脊柱矢状面アライメントを評価した．

結果：術後後弯は26％で発生し，鎌田の分類でlordosis typeを呈する症例では術後後弯は発生せず，後弯群では，術前C2-7角，C2-7 SVAが小さかった．

まとめ：術前に頚椎前弯が小さく，直線化した頚胸椎アライメントは，術後頚椎後弯のリスクとなる．

参考文献

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