胸椎黄色靱帯骨化症の手術方法 : 3D-CT の観点から

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The wide use of CT and MRI have increased the opportunity to diagnose ossified thoracic yellow ligament (OYL) more precisely and, furthermore, the recent advances of 3-dimensional CT (3D-CT) images have made it possible to remove OYL completely and safely by providing more detailed information concerning the anatomy of OYL and the surrounding structures. Forty patients with OYL (64 spine levels) operated were classified into two groups; i.e. bilaterally separated and extended type and medially enlarged type of OYL, according to OYL configurations pictured in 3D-CT images. The key point for successful surgery of OYL is to clarify the border zone between OYL and the normal dura to initiate OYL removal after making a small hole on the lamina near midline in the former group, and the 3D-CT images is useful to clarify the cranial and caudal ends of OYL in the latter group. To perform satisfactory surgery for OYL, the following three points are stressed; firstly, to obtain precise 3 dimensional anatomical images of OYL and the surrounding structures by 3D-CT (if needed, stereo-images), secondly, to remove OYL completely, extending to the foramen and, thirdly, make the thick OYL paper-thin by a high power drill, making the removal procedure easier and safer. By adopting 3D-CT images for planning of surgical approaches to OYL, the procedure of the removal of OYL has been improved and has become more less invasive for the patients.
日本脊髄外科学会の論文
1999-11-30

胸椎黄色靱帯骨化症の手術方法 : 3D-CT の観点から

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