整形外科と災害外科
Online ISSN : 1349-4333
Print ISSN : 0037-1033
ISSN-L : 0037-1033
頸部脊椎骨軟骨症の観血的療法について
服部 奨
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ジャーナル フリー

1967 年 17 巻 1 号 p. 7-13

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An examination was made on the results of the operative treatment performed on 51 patients with the cervical osteochondrosis in our clinic from 1957 to 1969. The operative methods performed were laminectomy, Robinson-Smith's method, Cloward's method, and the foraminectomy of Frykholm. In the 51 patients, the spinal cord compression syndrome was observed in 21 patients and the radicular syndrome in 30.
Generally, the methods of Robinson-Smith and Cloward produced better results than those of laminectomy in both the groups with the spinal cord compression syndrome and with the radicular syndrome.
Both Robinson-Smith's method and Cloward's method were effective for the patients with the radicular syndrome, and generally the latter were better than the former. Especally in the cases with the cervical spondylosis (e. g., posterior spur formation), the latter was definitely better.
For the cases with radicular syndrome, the partial laminectomy, like foraminectomy, produced good results, but for the cases with the disc degeneration, we take the vertebral body fusion as the first choice of the methods.
In our experience, the results of the operative treatment were better in the cases with the spinal cord compression syndrome than those with the radicular syndrome. Therefore the reasons were discussed, and it was emphasized to select the indication strictly.
In the cases with the spinal cord compresseion syndrome, the relationship between the clinical findings and the results of the operative treatment was examined. The results were generally unsatisfactory in the following cases; i. e., the cases with the syndrome for a long-lasting period, severe spastic paralysis in the lower extremities, and the severe cervical spndylosis in many vertebra.
About the X-ray findings of the cervical vertebra on which the vertebral body fusion had been performed, a discussion was made on the state of the bony fusion, localized kyphosis, and the compensatory changes of the upper and lower discs of the fused vertebral body.

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