Selective Posterior Decompression of the Cervical Spine
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概要
- 論文の詳細を見る
Posterior decompression of the cervical spine is an accepted treatment for patients with cervical canal disease, but some patients experience postoperative axial pain and C5 or C6 palsy that affect their quality of life. Here we describe selective posterior decompression using a spinous process-splitting approach to prevent these complications performed in 17 patients with myelopathy treated at median 2.4 levels by selective posterior decompression via the transspinous approach. Clinical symptoms, axial pain, and C5 or C6 palsy were compared before and after treatment. The range of motion of the cervical spine and shift of the cervical cord were studied at the C5 level. All patients experienced symptom improvement and none suffered deterioration or required reoperation. The Japanese Orthopaedic Association score improved from 10.9 to 14.4 points and none of the patients reported C5 or C6 palsy or axial pain at the last follow-up visit. There was no statistically significant change in pre- and postoperative cervical alignment and range of motion. The posterior shift of the spinal cord at the C5 level was 1.7 mm. None of our 17 patients experienced significant postoperative axial pain after selective posterior decompression via the transspinous approach. Minimal spinal cord shift at the C5 level may have contributed to the reduced incidence of postoperative C5 or C6 palsy in our series. Selective posterior decompression is less invasive and effective in some patients with cervical canal disease.
- 2011-02-15
著者
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TERAMOTO Akira
Departments of Neurosurgery, Nippon Medical School
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Matsumoto Ryoji
Department Of Physics Graduate School Of Science Chiba University
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Matsumoto Ryoji
Department Of Citrus Research National Institute Of Fruit Tree Science
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Mishina Masahiro
Positron Medical Center Tokyo Metropolitan Institute Of Gerontology
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Mishina Masahiro
東京都老人総合研究所ポジトロン医学研究施設
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Mishina Masahiro
日本医科大学千葉北総病院 神経内科
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Mishina Masahiro
放射線医学総合研究所分子イメージング研究センター 先端生体計測研究グループ
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Mizuno Masaki
早稲田大学 人間科学研究科
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Teramoto Akira
Department Of Neurosurgery Nippon Medical School
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KIM Kyongsong
Department of Neurosurgery, Chiba Hokusoh Hospital, Nippon Medical School
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ISU Toyohiko
Department of Neurosurgery, Kushiro Rosai Hospital
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MISHINA Masahiro
Department of Neurosurgery, Chiba Hokusoh Hospital, Nippon Medical School
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YOSHIDA Daizo
Department of Neurosurgery, Nippon Medical School
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KOBAYASHI Shiro
Department of Neurosurgery, Chiba Hokusoh Hospital, Nippon Medical School
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Yoshida Daizo
Department Of Neurosurgery Nippon Medical School
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Mizuno Masaki
Faculty Of Sport Sciences Waseda University
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SUGAWARA Atsushi
Department of Gastroenterology, Yodogawa Christian Hospital
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Teramoto Akira
The Department Of Neurosurgery Nephrology And Rheumatology Nippon Medical School
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Matsumoto Ryoji
Department Of Neurosurgery Kushiro Rosai Hospital
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MORIMOTO Daijiro
Department of Neurosurgery, Kushiro Rosai Hospital
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ISOBE Masanori
Department of Neurosurgery, Kushiro Rosai Hospital
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Kominami Shushi
Department Of Neurosurgery Chiba Hokusoh Hospital Nippon Medical School
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Isu Toyohiko
Department Of Neurosurgery Hokkaido University School Of Medicine
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Isobe Masanori
Department Of Neurosurgery Kushiro Rosai Hospital
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Isobe Masanori
Department Obstetrics And Gynecology Osaka Rosai Hospital
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Kim Kyongsong
Department Of Neurosurgery Chiba Hokusoh Hospital Nippon Medical School
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Kim Kyongsong
Department Of Neurosurgery Chiba Hokuso Hospital Nippon Medical School
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Kobayashi Shiro
Department Of Neurosurgery Neurological Institute Chiba Hokuso Hospital Nippon Medical School
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Sugawara Atsushi
Department Of Biomolecular Engineering Graduate School Of Engineering Tohoku University
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Kobayashi Shiro
Department Of Neurosurgery Chiba Hokuso Hospital Nippon Medical School
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Mishina Masahiro
Department Of Neurosurgery Chiba Hokuso Hospital Nippon Medical School
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Morimoto Daijiro
Department Of Neurosurgery Chiba Hokuso Hospital Nippon Medical School
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Kitamura Shin
The Second Department Of Internal Medicine Nippon Medical School
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Kobayashi Shiro
Department Of Material Chemistry Graduate School Of Engineering Kyoto University
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Teramoto Akira
Department Of Functional Polymer Science Shinshu University
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Sugawara Atsushi
Department Of Neurosurgery Iwate Medical University
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Mishina Masahiro
Department Of Neurology Nippon Medical School Chiba-hokusoh Hospital
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MISHINA Masahiro
Department of Internal Medicine, Nippon Medical School
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