臨床整形外科55巻7号

2020年07月発行

特集 脊椎手術—前方か後方か？

頚椎症性脊髄症に対する手術方法—前方法，後方法のDecision Making

著者： 吉井俊貴¹ 平井高志¹

所属機関： ¹東京医科歯科大学整形外科学分野

ページ範囲：P.799 - P.803

　Cervical spondylotic myelopathy(CSM)に対する術式として，前方除圧固定術と後方椎弓形成術が代表的であるが，術式選択に関して明確な指標はない．われわれは，前向き比較研究で，術後5年においては，前方法が椎弓形成術よりも成績が良好であることを確認している．また椎弓形成術の中で成績不良となる因子として，術後の脊髄前方圧迫残存があげられる．前方圧迫残存はModified K-lineを使用して，ある程度，予測可能であり，術式選択の具体的な指標として有用である．ただし前方法は合併症発生率とコストが高く，術式選択の際にはこれらを含め総合的に判断する必要がある．

参考文献

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