頸部脊髄症に対する再手術例の検討

抄録

We will report on twenty-eight case studies of patients with recurrent cervical myelopathy who underwent reoperations between 1980 and 1991. They consisted of 19 patients with cervical spondylotic myelopathy and 9 patients with OPLL. At first operation, 26 patients had anterior fusions, and 2 patients had laminectomies. Of the 26 anterior fusion qroup, anterior fusions at the adjacent intervertebral level were performed on 8 patients, expansive laminoplasties on 15 patients, and laminectomies on 3 patients. Anterior fusions were performed on the 2 laminectomy patients. The causative factors of the reoperations were as follows: -14 patients (50%) had a cord compression at the ajacent level, 4 had canal stenosis, 4 had insufficient decompression, 3 had a progression of the OPLL, 2 had a kyphotic deformity, and had a traffic accident. In our follow-up studies over an average of 2 years and 9 months, excellent and good results were obtained in 11 patients (39%), poor in 10, unchanged in 5, and worse in 2.
From these results, we conclude that the operative procedures and levels of cervical myelopahy should be decided after an accurate neurological and image evaluation of the affected levels.