頸腕障害の知覚障害像

THE FEATURES OF SENSORY DISTURBANCES IN CERVICAL SYNDROME

　（1）知覚障害の程度は一般に軽く，高度のものは少ない。

　（2）障害は上肢に初発し，下肢に続発して上行拡大うる。

　（3）範囲および程度に左右差がある。しかし，Brown-Sequard様障害像，明らかな離伴性知覚障害を示したものはない。

　（4）障害の進行経過はきわめて遅く，上肢または四肢に障害があつて体幹に障害のない時期がある。

　（5）椎弓切除と歯状靱帯切断による除圧減張で知覚障害はかなり改善される。

　（6）術前知覚障害像および手術時脊髄所見から，ある程度術後の知覚障害の回復性を予測することができる。

Sensory disturbances were investigated on 17 patients in whom spinal cord and nerve roots compression due to cervical spondylosis were demonstrated at operation. We limited cases to cervical spondylosis and only discuss-ed sensory problems in this paper. 13 patients were male, and 4 patients female. The youngest was 38, and the oldest 69 years of age. In each case cervical laminectomy, release of meningeal adhesions and section of dentate ligaments for decompression were performed. The removal of hard bars or bone ridges was not indicated in any case. Cutaneous and deep sensations were examined.

1) The sensory signs and symptomes at first appear on the upper extremities, next on the lower extremities and then gradually extend to the trunk ascendently.

2) The sensory involvements ane rather slighter than in any other spinal cord disease, so authers seldom see a extemely severe case in cervical spondylosis.

3) The sensory impairments are asymmetric in the trunk and extremities, but not similar to a Brown-Sequard syndrome or a dissociated pattern.

4) The sensory symptoms are improved by the decompressive laminectomy and section of dentate ligaments.