脊髄髄内病変に対する root entry zone よりのアプローチについて

概要

論文の詳細を見る
Midline myelotomy is commonly selected as the site of surgical approach for spinal intramedullary lesions, such as intramedullary ependymomas and astrocytomas, which mostly grow symmetrically in the midline. A posterolateral approach through the root entry zone (REZ) can, however, be used for some limited lesions developing in the lateral part of the spinal cord, such as cavernous angiomas and hemangioblastomas. Because of the recent trend towards less invasive surgery, the hemilaminectomy method is becoming more popular for the surgery of dumbbell-typed schwannoma and meningioma etc, and, accordingly, intramedullary lesions existing in the lateral part of the spinal cord can also be approached through REZ after hemilaminectomy. We have carried out this surgical approach in five cases of intramedullary lesions; they were 2 cavernous angiomas and 3 syringomyelias with Chiari type 1 malformation. This surgical approach is useful for preserving the normal function of the posterior column of the spinal cord and for avoiding postoperative kyphotic deformity of the spine even in young patients of Chiari type 1 malformation.
日本脊髄外科学会の論文
1999-11-30