頚椎症性脊髄症に伴う頚部痛の術後早期変化

Comparative Study of Neck Pain Before and After Cervical Laminoplasty

　頚椎症性脊髄症に伴う頚部痛の椎弓形成術後の変化をプロスペクティブに調査した．頚部痛を有する頚椎症性脊髄症患者21名を対象とし，術前と術後2週で痛みの部位と程度を調べた．術後は7例で痛みを認めず，14例で痛みを認めた．14例中，術前と同部位は10例，術後新たな部位に生じたのが4例であった．術前VASは4～10（7.2±1.5）で，術後は0～8（2.3±2.7）であった．痛みが残存した10例中9例でVASは改善していた．今回の結果から，頚椎症性脊髄症に伴う頚部痛を椎弓形成術により治療できる可能性が考えられた．しかしその機序は不明で，今後の研究を要す．

　Patients with axial symptoms caused by cervical myelopathy were evaluated before and after cervical laminoplasty. VAS scores and symptom location were evaluated in 21 patients on postoperative day 14. Seven patients were pain-free, and ten had axial pain in the same location as before surgery. The other four patients subsequently developed pain at a different location. The VAS score after surgery had significantly improved, from a range of 4 to 10 (average：7.2) to from 0 to 8 (average：2.3). We concluded that the axial symptoms were improved by cervical laminoplasty, but further study is needed to understand the mechanism responsible for the axial symptoms.