頚椎変性疾患再手術例の検討

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  • Study of Re-Operation for Cervical Diseases

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The author presents a study on the primary operative techniques in cases of cervical degenerative disease (CDD : spondylosis, disc hernia, and ossification of the posterior longitudinal ligament) requiring re-operation. Re-operation was required in 30 cases from a total of 539 operations for CDD in the period from April 1996 to December 2000. The age range at re-operation was from 22yr to 79yr, with 18 males and 12 females comprising the 30 patients. The period between the primary procedure and reopration ranged from 4 months to 18yr. Primary operation via the anterior approach was performed in 23 of the 30 patients. Deterioration of the nervous system was caused by a new stenosis in 15 patients, restenosis at the first level in 5 cases and non-union in 3 cases. The anterior approach was employed for re-operation in 8 patients, and the posterior approach in the remaining 14 patients combined approach in one case. In seven patients, deterioration was seen yet again, caused by kyphotic cervical spine in 5 patients and restenosis in 2. Re-operation was once again performed via the anterior approach in 5 patients and via the posterior approach in 2. In order to forestall re-operation, there are twe important considerations. First, an operation via the anterior approach is effective for stenosis of the lateral spine canal, but in cases involving stenosis of multiple segments, the posterior approach is required. Second, in cases of spinal column stenosis the procedure of chive is via the posterior approach, but in patients with cervical kyphosis the anterior approach should be considerd.

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  • 脊髄外科

    脊髄外科 16 (2), 127-134, 2002

    日本脊髄外科学会

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