頚椎脊柱管拡大術中の脊髄血流量測定と術後成績の関係 (第2報)

抄録

Circulatory factors are important in achieving a good outcome following surgical treatment of cervical myelopathy. However, it is difficult to measure spinal cord blood flow (SCBF) during surgery. We measured SCBF, before and after decompression of the cervical spine, in posterior median lesions by using laser-doppler flometry. We evaluated the relationship between surgical result and the change of SCBF after decompression, and compared SCBF with morphological changes in the spinal cord on magnetic resonance imaging (MRI) before and after surgery. Subjects comprised 13 patients with cervical spondylotic myelopathy and 15 patients with cervical myelopathy due to ossification of the posterior longitudinal ligament. The average SCBF before deconpression was 32.2ml/min/100g and after decompression, 19.2ml/min/100g, revealing that SCBF decreased in most cases after decompression. The change of SCBF after decompression affected the improvement of neurological deficits at follow up. There was no relationship between the change of SCBF and the morphological change of the cord on MRI. Measurement of SCBF using laser-doppler flometry during decompression of the cervical spine is useful for predicting the surgical result.