小児環軸関節回旋不安定症の治療困難例に対する手術療法

C1/2 Spine Fusion Surgery for Pediatric Atlantoaxial Rotatory Subluxation

目的：小児環軸関節回旋不安定症の治療困難例を手術的に治療したので，その経過を報告する．

対象と方法：保存的治療で改善が得られなかった小児7例に対し，環軸椎後方固定術を施行した．

結果：3例にBrooks法を，4例にMagerl ＆ Brooks法を施行し，全例で骨癒合が得られ，症状は消失した．術後経過平均7年時，頚椎の可動域は全例正常であった．

結語：Brooks法は3歳以上，Magerl ＆ Brooks法は7歳以上の症例で施行でき，経過観察中，再発や可動域制限などの問題は生じていない．

Objectives：To report our experience with treatment of atlantoaxial rotatory subluxation in children by fusion surgery.

Materials and Methods：Atlantoaxial fusion surgery was performed in patients who could not be cured conservatively.

Results：The Brooks method was performed in 3 cases and the Magerl and Brooks method in 4 cases.　Bony fusion of the atlantoaxial spine and resolution of symptoms, including neck pain, torticollis, and myelopathy, was achieved in every case.　Postoperative examinations revealed almost full ranges of neck motion.

Conclusions：It was possible to perform the Brooks method in patients over 3 years old and the Magerl and Brooks methods in patients over 7 years old.　All of the patients experienced resolution of symptoms and had no complications.