C6，C7項靱帯付着部温存は椎弓形成術後の前弯維持に有効である

Preservation of the Attachedment of the Nuchal Ligament to the Spinous Process of C6 and C7 Prevents Undesirable Radiographic Changes after Cervical Laminoplasty

　頚椎症性脊髄症に対してC2，C7両棘突起付着筋と蝶番側深層伸筋を温存するC3-C6椎弓形成術を施行した37例のうち19例でC6，C7両棘突起の項靱帯索状成分付着部を温存し（C6＋7温存群），18例でC7のみの付着部を温存した（C7温存群）．術後C2-C7角およびC6/7角の減少はC6＋7温存群でC7温存群より有意に小さかったが，両群間で頚椎可動域の減少や軸性疼痛の発生頻度に有意差はなかった．C6，C7両棘突起への項靱帯索状成分付着部の温存は椎弓形成術後の頚椎前弯の維持に有効であった．

　The subjects were 37 cervical spondylotic myelopathy patients who were treated by our modified method of C3-C6 laminoplasty. The attachment of the funicular section of the nuchal ligament to the C7 spinous process alone was preserved in 18 patients (C7 group), and its attachment to the spinous process of both C6 and C7 was preserved in 19 patients (C6＋7 group). Postoperative loss of lordosis and destabilization at the C6/7 segment were significantly reduced in the C6＋7 group in comparison with the C7 group. Postoperative loss of cervical range of motion and frequencies of axial neck pain showed no significant differences between the two groups. These results indicate that the preserved funicular section of the nuchal ligament attached to the spinous process of both C6 and C7 plays an important role in preventing undesirable radiographic changes after laminoplasty.