透析患者における頚椎破壊性脊椎関節症 9 例の経験

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The experience of cervical destructive spondyloarthropathy in 9 hemodialysis patients is reported and a favorable operative method is discussed from the viewpoint of analysis of the x-ray findings. Cervical destructive spondyloarthropathy was mainly found in the C3-4, C4-5 level in 5 cases and in the C4-5, C5-6 level in 3 cases. Kyphotic deformity frequently existed around the C4 and C5 level. Overall, anterior displacement of the 3rd vertebra over the 4th vertebra and posterior displacement of the 5th vertebra over the 6th vertebra were observed most frequently. The vertebral body was deformed at the 4th and 5th vertebral level. During the surgical procedure, the compressed vertebral body should be decompressed anteriorly as much as possible and bone transplantation should be performed between the normal vertebral bodies. Internal fixation should be done with an anterior cervical plate system and/or a pedicle screw system when intervertebral fusion is performed at more than two levels. In addition, external fixation with a Halo vest might be necessary in some cases.
日本脊髄外科学会の論文
2002-11-30