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頸椎後縦靱帯骨化による頸髄障害に対する手術法は,まだ確立されておらず,前方固定術3)23)7),減圧椎弓切除術2)16)17)7)あるいは両者併用3)18)など種々の論議がある。著者はこの手術法について,まず屍体を用いて研究し,Bilateral multiple facetectomy, extensive laminecto—my with or without foramen magnum decompressi—onが合理的であることを知り,1964年以降,10例に本法を行ない,最長6年有余の観察で,好結果を得た。
レ線上,本骨化の初期変化を含めて,18例の頸椎後縦靱帯骨化について,脊椎全般のレ線学的検索を行なつた。そして,本症とCervical spondylosis, Forestier's senileankylosis hyperostosis20)との関連について考察した。
Surgical procedure presented here was evolvedfrom observations either in cadavers or in the cer-vical vertebral columns removed en bloc at autopsy.Ventro-doral pressure was excerted to the ventralaspect of the dural tube through a burr hole placedin the vertebral bodies and the effects of dorsalmigration were compaired between the cases with laminectomy alone and with laminectomy plusbilateral facetectomy. More extensive dorsal migra-tion was obtained by bilateral facetectomy pulslaminectomy. No limitation of movement of cer-vical cord was observed by the dentate ligament tothe ventro-doral pressure.
Ten case of the ectopic ossification of the post-erior longitudinal ligament producing spinal cordcompression have been described. Although thisdisease may represent a different manifestation ofthe degenerating changes, this disease should beincluded in the differential diagnosis of cervicalmyelopathy because of its unique clinical, radiolo-gical and pathological behaviour and it seems toconstitute a distinct clinical entity. Ten patientstreated by the extensive decompressive laminectec-tomy with or without foramen magnum decom-pression associated with bilateral multiple facetec-tomy had favorable results. Postoperative myelo-graphy demonstrated the rationale with dorsalmigration of the entire dural contents.
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