頚椎後縦靱帯骨化症に対する C2 dome laminectomy を併用した片開き式脊柱管拡大術の手術成績

抄録

We carried out a retrospective case-controlled study of alignment and clinical results of C2 dome laminectomy for myelopathy in ossification of the posterior longitudinal ligament (OPLL). While resection of the C2 lamina is reported to lead to kyphosis after laminectomy, laminoplasty can reportedly inhibit this kyphosis. We studied 18 patients with myelopathy in OPLL for whom C2 dome laminectomy was added to open-door laminoplasty. The follow-up period averaged 35.6 months. Outcome was assessed in terms of the Cobb angle between C2 and C7, and the Japanese Orthopedic Association (JOA) motor function scores for the upper and lower extremities for cervical myelopathy. The C2-C7 angle averaged 10.2° before surgery, and decreased to 7.1° after surgery. The JOA score averaged 10.9 before surgery, and increased to 13.5 after surgery. These results were not worse than those for patients undergoing laminoplasty only. We concluded that the clinical results of C2 dome laminectomy were good, although careful follow-up of these cases will be necessary.