頸椎前外側削開術術後長期経過例における椎間腔高位の変化

—Preliminary Report—

抄録

  Anterolateral partial vertebrectomy, a new operative technique which involves drilling into the anterolateral part of the vertebral bodies, enables radical resection of the lesion, without any fusion. The procedure, however, could possibly promote disc degeneration and, as a result, reduce disc height because of resection of the lateral part of the disc. The authors describe long-term results of disc height change after anterolateral vertebrectomy of the cervical spine.

  This study involved 11 patients (7 men and 4 women) ranging in age from 41 to 71 years. The follow-up period was from 4 to 13 years (average 6 years). Neurological findings were evaluated using NCSS before and after surgery and at the end of the follow-up period. The disc height was measured by using slide calipers before surgery and at the end of the follow-up period. In this study, 19 operated discs and 32 non-operated discs were used. The residual rate as represented by formula (disc height at the end of the follow-up period/disc height before surgery) was compared between operated discs and non-operated discs. The Student's t-test was used for comparison between the groups.

  In all but one case, NCSS was improved after operation and remained so during the follow-up period. In one patient who had complained of numbness in all 4 extremities due to cerebral palsy, NCSS was consistent during the follow-up period. The residual rate did not differ significantly in the operated group from the non-operated one (0.85±0.13 vs. 0.89±0.10). In the subgroup whose disc height was 5 mm or more, the residual rate did not differ significantly in the operated subgroup from non-operated one (0.82±0.13 vs. 0.88±0.12).

  This study suggests that the injury to the disc in anterolateral vertebrectomy does not influence on disc height. Anterolateral vertebrectomy seems to be a useful surgical option for degenerated cervical spinal disorders.