上肢遠位筋優位の萎縮を特徴とした頚椎後縦靱帯骨化症の1例

Muscular Atrophy in the Distal Upper Extremity Secondary to Ossification of the Posterior Longitudinal Ligament : Case Report

　抄録：今回われわれは，上肢遠位筋優位の萎縮を特徴とする頚椎症性筋萎縮症と同様の機序にて発症したと考えられる頚椎後縦靱帯骨化症の1例を経験した．本症例では，神経症状と画像所見から考えて，前角の病変が考えられた．上肢遠位筋優位の筋萎縮は，一般的に良好な治療成績が得られにくいといわれているが，本例では脊柱管拡大術にて良好な結果が得られた．発症後約4週間の時点で手術が行われた点，手術時の筋力が3と低下が軽度であった点より，脊髄病変に十分な可逆性があった時点で手術ができたことが，良好な結果が得られた要因と考えられた．

　We report a case of muscular atrophy in the distal upper extremity secondary to ossification of the posterior longitudinal ligament in the cervical spine. Based on the physical findings and results of MRI examinations and CT myelograms, the main lesion was suspected of being localized in the anterior horn of the 8th segment of the cervical spinal cord. It is well known that the surgical outcome of muscular atrophy in the distal upper extremity secondary to cervical spondylotic amyotrophy is poor, but the results in our patient were satisfactory. Possible reasons for the success were the fact that surgery was performed about four weeks after the onset of symptoms and the fact that the loss of strength at the time of surgery was mild. Early surgical treatment was concluded to be important.