頚椎症性脊髄症に対する除圧術が交感神経に及ぼす影響について

Effects of Cervical Decompression on Sympathetic Nerve Activity in Patients with Cervical Spondylotic Myelopathy

　脊髄症状以外に交感神経症状を呈した頚椎症性脊髄症7例に対して除圧術を施行したところ，全例に交感神経症状の消失・改善，筋交感神経活動の有意な低下を認め，7例中6例に高血圧の改善を認めた．このことから頚椎症性脊髄症において頚椎・頚髄内の中枢自律神経線維網（CAN）の上行・下行路が障害された場合に交感神経抑制機能が低下し，様々な交感神経亢進症状を引き起こす可能性があると考えた．また除圧によってCANの機能が改善し，交感神経症状が脊髄症状とともに改善すると推測した．

　In all 7 patients with cervical spondylotic myelopathy and symptoms of sympathetic hyperactivity, sympathetic symptoms improved and sympathetic nerve activity decreased after cervical decompression. Furthermore, preoperative hypertension was normalized postoperatively in 6 patients. These results suggest that compression of the spinal cord in patients with cervical spondylotic myelopathy may cause dysfunctions in the afferent and efferent tracts of the central autonomic network (CAN) and secondary CAN disorders, resulting in manifestations of sympathetic hyperactivity. In addition, cervical decompression seemed to improve not only myelopathy, but also sympathetic hyperactivity in these cases.