頸椎々間板症に対する前方固定術の反省

抄録

A series of 32 cases with cervical disc lesions has been studied and followed for 6 months to 4 years after anterior cervical fusion according to the technique of Robinson-Smith or Cloward.
The series has been divided into four categories depending on whether the lesion was a soft deplaced disc or hard arthritic spur and whether the presenting complaint was of segmental origin or spinal cord embarrassment.
It has been found that results of surgery for the segmental syndromes originating from herniating soft disc are very good.
Of patients with spinal compression syndromes originating from arthritic spur 11% have satisfactory results.
The results are generally unsatisfactory in the following cases: severe spastic paralysis in the lower extremities, and the severe cervical spondylosis in many vertebral bodies.
Cloward's method has failed to correct the anterior angulation of the cervical spine in 7 cases but has induced the remodeling of bony spurs in 2 cases.
The severe change of the upper disc of the fused vertebral body are found in one case who gave a history of trauma.
We suggest that anterior interbody fusion should be used only in those cases with a clncally and radiologically localized process without severe cervical spondylosis in many vertebrae.