胸髄腫瘍摘出後脊柱後弯症の1例

Treatment of Severe Kyphotic Deformity after Surgical Treatment of Intramedullary Spinal Cord Tumor. Case Report

　小児脊髄髄内腫瘍において椎弓切除，放射線治療を受けた後，成長に伴い後弯を主とした脊柱変形が進行していくことはよく知られており，その治療に困難を極める例も少なくない．筆者らは胸髄腫瘍術後高度後弯変形を経験し前後方矯正固定術を行った．症例は11歳の男児で，他院にて胸髄髄内腫瘍摘出の際，頚椎椎弓形成術，胸椎椎弓切除術が行われた．その後に腫瘍摘出前の胸椎後弯変形51°が8カ月で110°と進行した．術前にhalo牽引を行い神経学的に変化なく矯正が可能であることを確認し，二期的に後方矯正固定-前方固定術を行い，良好な結果を得た．

　Spinal column deformity is not uncommon after cervical or thoracic laminectomies and radiational therapy for spinal cord tumors in children, but surgical treatment for this deformity is not easy. We performed two-staged correction and fusion for severe kyphotic deformity for 11-year-old boy who had undergone thoracic laminectomies and radiationnal therapy. The patients we presented had a past history of multiple operations and irradiation because of intramedullary spinal cord tumor, and demonstrated a severe postlaminectomy kyphosis. We performed two-staged posterior-anterior operation and succeeded in correctioning kyphosis from 110°to 56°．