解剖学的（神経学的）診断と画像診断の乖離

Dissociation of Anatomical (Neurological) Diagnosis and Imaging Diagnosis

脊椎・脊髄疾患の診療において障害高位の同定は不可欠であり，解剖学的（神経学的）診断と画像診断により判断されるが，ときに両者の乖離に遭遇する。この乖離を生じやすい病態として，①頸髄髄節高位のずれ，②中心性脊髄損傷を含む頸髄中心性障害，③頸部神経根症の感覚障害領域，④脊髄円錐上部・円錐部障害，⑤脊髄係留症候群，⑥腰部神経根の椎間孔障害があり，これらの病態を十分理解しておく必要がある。

Abstract

Identification of various spine and spinal cord disordes using anatomical diagnosis (neurological diagnosis) and imaging diagnosis is essential for effective caring of patients with these disorders; however, sometimes, dissociation of the two diagnoses is encountered. There is a risk of a diagnosis error if the causative pathophysiology of this dissociation is not understood. To avoid this error, it is necessary to fully understand the related pathophysiology of these disorders, including deviation of spinal cord segment from the spine, central cord syndrome, sensory disturbance of cervical radiculopathy, epiconus syndrome and conus medullaris syndrome, tethered spinal cord syndrome and lumbar intraforaminal and extraforaminal nerve root disturbance.