鎖骨・頭蓋異形成症（cleidocranial dysostosis）に発症した後側弯症の1例

Treatment of Kyphosingscoliosis Complicating Cleidocranial Dysplasia. Case Report

　鎖骨・頭蓋異形成症に伴う後側弯症に対し，矯正固定術を施行した．症例は10歳の女児である．生下時に鎖骨・頭蓋異形成症の診断をされ，脊柱変形のため，Risser-Cotrel cast，装具治療で後側弯の進行予防に努めていたが，6歳頃から進行し始め，8歳時には70°台に悪化したため，手術を予定した．単純X線像では，76°の側弯，胸椎66°の後弯，3DCTでは胸椎椎体前方の形成異常，癒合不全を認めた．前後方矯正固定術を行い，胸椎カーブは18°，後弯も25°と矯正された．初診時64°の側弯を認めたが，早期から保存治療を行うことで側弯進行を予防し，10歳時に固定術を行った．

　The patient was a 10-year-old female with cleidocranial dysostosis who had been referred to our clinic for spinal deformity at two years of age. Radiograms at that time revealed a right thoracolumbar curve of 64 degrees. Risser-Cotrel cast and brace treatment were performed to prevent progression of the spinal deformity for about 8 years. At 10 years of age, when the scoliotic curve was 76 degrees and the kyphotic curve was 66 degrees, anterior release and posterior/correction and fusion (T2-L3) was performed. A postoperative, plain X-ray showed correction of the scoliosis to 18 degrees, and of the kyphosis to 25 degrees, with no neurological changes. Despite the scoliotic angle of 64 degrees, it was possible to prevent progression of the spinal deformity by cast and brace treatment, and to perform the final fusion at the ten years of age.