頸椎後縦靭帯骨化症の手術

概要

論文の詳細を見る
Some 3-5% of Japanese over the age of 40 are estimated to have ossification of the posterior longitudinal ligament (OPLL). Few, however, require surgery, and surgical indications and procedures remain controversial. We evaluated two surgical procedures and present cervical OPLL treatment indicators. Our cervical OPLL series consisted of 163 surgically treated patients, 102 men and 61 women (average age : 57.1 years), 80 undergoing anterior decompression and 83 patients posterior decompression. Results showed 142 (88%) improved, 12 (7%) slightly improved, (4%) remained unchanged and 2 became worse. Postoperative complications occurred only in anterior-decompression cases, and involved grafted bone dislocation in 5 cases, subcutaneous CSF leakage in 5, C5 radiculopathy in 3, and anterior iliac crest fracture in 1. Anterior and posterior approaches cannot be easily compared, but our results suggest postoperative prognosis was satisfactory in both groups but posterior decompression was safer. Surgery should therefore be considered if further motor weakness develops or has existed as a sign of myelopathy.
日本脊髄外科学会の論文
1999-03-31