Scheuermann病を合併した胸椎すべり症の1例

Spondylolisthesis of the Thoracic Spine with Scheuermann's Disease. Case Report

　Scheuermann病を合併した胸椎すべり症の1例を経験した．胸椎単純X線側面像でT11/12高位に前方すべりならびにT12，L1，L2椎体の楔状化とT11-L3間の後弯変形を認めた．すべり高位に明らかな不安定性を認めなかったが，除圧単独のみを行った場合にはScheuermann病による脊柱変形が術後の脊柱後弯変形を進行させることが危惧され，T11，12，L2，3の椎弓切除術にT10-L3の後方固定術を追加し，良好な術後成績を得た．後弯変形を有する胸椎すべり症に対しては，除圧術と後方固定術を行うことが有用であると考えられた．

　We report a case of spondylolisthesis of the thoracic spine with Scheuermann's disease.　A 66-year-old man was admitted because he presented dysesthesia of bilateral lower extremities, and gait disturbance associated with spastic paraparesis in a few months.　Spondylolisthesis at T11/12 level was observed on plain thoracic radiograph.　Wedge deformity was observed on T12, L1, and L2 vertebral bodies in which wedge angles were greater than 5 degrees respectively.　Kyphotic deformity was also observed between T11 and L3 of 39 degrees.　With these findings, spondylolisthesis of the thoracic spine with Scheuermann's disease was diagnosed.　Laminectomies at the levels of T11, 12, L2 and L3 were performed.　In addition, postero-lateral fusion from T10 to L3 was performed to evade post-laminectomy kyphosis.　Six months after surgery, his neurological symptoms had improved.　This is the first report of spondylolisthesis of the thoracic spine with Scheuermann's disease.　Our surgical strategy was an effective choice of treatment.