下垂指（drop finger）を来す頚部神経根症

Cervical Radiculopathy Causing Drop Finger

　抄録：下垂指（drop finger）を来す頚部神経根症の特徴的な症候，障害神経根の高位，そして手術に踏み切った際の成績が不明である．後方から椎間孔拡大術が行われた全12例をretrospectiveに検討して次の結論が得られた．①肩甲間部あるいは肩甲骨部の痛みで発症し，その後に下垂指が生じる．②初診時に，上肢あるいは手指の痛み・しびれを欠く例が稀でない．③全例で上腕三頭筋と手内在筋に筋力低下がみられ，その程度は手内在筋で強い．④障害神経根は，ほとんどがC8神経根であり，C7神経根は少ない．⑤手術による下垂指の改善の程度は，良好例と不良例が相半ばする．⑥神経根症による下垂指は，より良好な成績を得るために，保存療法を介さず，迅速に手術に踏み切ってよい．

　The symptomatology, nerve root levels involved, and results of surgical treatment of the cervical radiculopathies that cause drop finger have not been clarified. A retrospective review of 12 cases in which posterior foraminotomy had been performed to treat cervical radiculopathy led to the following conclusions. 1：Pain in the interscapular or scapular region precedes the occurrence of drop finger. 2：Frequently there is no arm or finger pain at the time of the first examination. 3：The triceps brachii and intrinsic muscles of the hand are affected in all patients, and the weakness of the intrinsic muscles predominates. 4：The nerve root involved is almost always C8, and seldom C7. 5：Recovery of drop finger after surgery is good in half the patients and poor in the other half. 6：It is recommended that patients with drop finger secondary to radiculopathy promptly be treated surgically without conservative intervention, because better results can be obtained.