多椎体性頚椎 OPLL による脊髄症に対する expanding laminoplasty : 術式の工夫と長期成績

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Expanding laminoplasty with spinous process roofing technique has been employed for the treatment of multilevel cervical OPLL (ossification of the posterior longitudinal ligament) presenting myelopathy. The technique was unique for its simplicity and safety. This technique is a modification of the original Kurokawa's spinous process splitting technique. Twenty seven individuals were included in this treatment. Neurological evaluation was assessed by the Japan Orthpaedic Association Score and bony fusion was evaluated with bone window CT scan, and neck motion was assessed on the dynamic lateral cervical radiograph. There were 6 cases treated by 5 level laminoplasty, 13 cases by 6 level laminoplasty, 6 cases by 7 level laminoplasty and 2 cases by 8 level laminoplasty. Fourty two % increase in anterior-posterior diameter of the cervical spinal canal was achieved on average by expansion of this laminopalsty technique. Bony fusion rate between the opened laminae and spinous processes was 98%. Preoperative neurological JOA score was 7.8 on average while 14.0 postoperatively 3 years after the initial surgery. Postoperative neck motion was restored to 83% of preoperative range of motion. Although a variety of surgical techniques are available, our expanding laminoplasty with spinous process roofing technique is useful for the treatment of multilevel cervical OPLL because of its simplicity, safety, high bony fusion rate, and satisfactory postoperative neck motion improvement.
日本脊髄外科学会の論文
1999-11-30

多椎体性頚椎 OPLL による脊髄症に対する expanding laminoplasty : 術式の工夫と長期成績

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