Clinical Types of Myelopathy in Cervical Spondylosis

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概要

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• In studying the distribution of the stresses in compression of the cord which are obtained by the photo-elastic experimental analysis of the cross section models of the cervical cord made of polyurethane rubber, we suggest that the characteristic cord lesions being the basis of myelopathy in cervical spondylosis may be formed for the ischemia precipitated by the stresses applied to the vessels within the cord. According to the severity of the cord lesions, myelopathy in cervical spondylosis can be conveniently devided into 3 types. That is, type I shows the symptoms due to the cord lesion in the central area, type 2 in the posterolateral area in addition to the symptoms of type I and type 3 in the anterolateral area in addition to the symptoms of type 2.Of the 47 cases diagnosed precisely as myelopathy in cervical spondylosis, 6 cases were included in type I, 9 cases in type 2 and 32 cases in type 3. Consequently, it becomes apparent that type 3 including advanced cases disturbed severely the gray matter and the anterior part of the posterior columns in the central area and the pyramidal tract in the posterolateral area, and slightly the spinothalamic tract in the anterolateral area, is the distinctive picture of myelopathy in cervical spondylosis.It is concluded that these experimental types coincide with the clinical types of cervical myelopathy from the neurological analysis of the symptoms.The classification of the neurologic symptoms into these clinical types is useful to differentiate myelopathy in cervical spondylosis from the other diseases similar to it.

• 西日本整形・災害外科学会の論文

著者

• 富永 積生

  島根県立中央病院

• 山県 秀也

  山口大学整形外科

• 西村 義昭

  厚生年金玉造整形外科病院

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