臨床整形外科53巻8号

2018年08月発行

誌上シンポジウム 椎弓形成術 アップデート

椎弓の切除幅を制限した選択的頚椎椎弓切除術は頚椎椎弓形成術特有の問題を回避し得る

著者： 白石建¹ 青山龍馬² 二宮研² 海苔聡² 上田誠司³ 山根淳一⁴ 北村和也⁵ 鈴木悟士⁶

所属機関： ¹白石脊椎クリニック ²東京歯科大学市川総合病院整形外科 ³川崎市立川崎病院整形外科 ⁴国立病院機構村山医療センター整形外科 ⁵済生会横浜市東部病院整形外科 ⁶慶應義塾大学医学部整形外科

ページ範囲：P.675 - P.684

　椎弓切除幅を脊髄横径＋2〜3mmに限定した選択的頚椎椎弓切除術は，椎間関節と関節包が完全に温存され，頚椎深層伸筋の損傷も少ないため，頚椎前弯が消失した例でも頚椎の弯曲が保持され，運動性と支持性が損なわれにくい．また，拡大椎弓の再閉鎖，ヒンジ骨折による椎弓の脊柱管内への陥込み，意図せぬ椎弓同士の骨癒合も起こり得ないため，椎弓の内固定は不要であり，後療法が簡素化され，早期社会復帰が可能である．本法は頚椎椎弓形成術特有の問題を回避し得る優れた術式である．

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