Posterior-lateral transdural approachにて摘出したretro-odontoid disc herniationの1例

Retro-odontoid Disc Herniation Extracted, Using the Posterior-lateral Transdural Approach: Case Report

Ⅰ．はじめに

　いわゆるretro-odontoid disc herniationは，病理組織学的に椎間板と一致する組織塊が歯突起後部に占拠する病変であり，頭蓋頸椎移行部の占拠性病変では稀なものである．しかし，その存在が知られるようになり，報告例も増加しつつある^2,7,9,11-13)．自験例を提示し，主に外科的治療方針についての考察を加える．

　A 73-year-old woman suffered from neck pain, progressive motor weakness and sensory disturbance in all extremities. Neuroradiological studies revealed a retro-odontoid mass with posterior compression of the upper cervical spinal cord. Decompression of the mass was performed via a postero-lateral transdural approach, and the patient exhibited marked improvement of the symptoms. Histological examination revealed that the mass was composed of degenerative cartilaginous tissue, consistent with disc material, but the lesion was not neoplastic. Retro-odontoid disc herniation causing cervical myelopathy is very rare. We primarily discuss the surgical management of retro-odontoid disc herniation.