頚椎前方除圧固定術—前方除圧の手術コンセプトと内固定材料の選択

Anterior Cervical Decompression and Fusion:Surgical Concept of Anterior Decompression and Selection of Internal Fixation Devices

Point

・頚椎前方除圧固定術は3椎間までの頚椎椎間板ヘルニア，頚椎症，後縦靱帯骨化症がよい適応である．

・術前症状と画像により病変切除範囲を決定し，固定インプラントを選択する．

・隣接臓器の損傷や術後血腫など，さまざまな合併症対策が必要である．

＊本論文中、［Video］マークのある図につきましては、関連する動画を見ることができます（公開期間：2028年2月まで）。

　Anterior cervical fixation is an excellent surgical technique for the removal of anterior compressive elements affecting the spinal cord and nerve roots while addressing cervical instability. However, it is important to recognize the unique challenges posed by the proximity of critical structures, including the trachea, esophagus, carotid sheath, and recurrent laryngeal nerve. Access to the upper cervical spine is often limited to the mandible.

　A thorough understanding of the relevant anatomy is essential for careful consideration of surgical indications when selecting an appropriate technique. By ensuring accurate decompression and stabilization, optimal postoperative outcomes in terms of neural symptom relief and spinal stability can be achieved.