頚椎 OPLL に対する Expanding Laminoplasty

概要

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This paper describes the technique of expanding laminoplasty employed for cervical OPLL (ossification of the posterior longitudinal ligament) patients and its results with 3 years or more follow-up. Several techniques are available in performing expanding laminoplasty for cervical myelopathy patients due to OPLL. Technical complexity and limitation of the postoperative neck movement remain as issues where improvement is desirable. Our technique is simpler than the other previous techniques and provides better post-operative neck movement in the long-term follow-up period. Twenty cervical OPLL patients were treated by expanding laminoplasty using spinous process roofing technique with follow-up period of 3 years or more. They were investigated for the expansion of the cervical canal, bone fusion on CT, neck movement on X-ray and neurological evaluation. Forty-two percent increase of cervical canal diameter was shown to have been achieved in average on lateral X-ray. On CT bone fusion rate was 96%. Post-operative neck movement was confirmed at 83% of the preoperative level. An average preoperative JOA score was 7.9, increasing to 14.1 at 3 years after operation. Based on these results, the technique we described here is safe and simple along with a high bone fusion rate as well as better postoperative neck movement than is found after other laminoplasties.
日本脊髄外科学会の論文
1997-06-16