胸椎黄靱帯骨化と脊髄障害

Myelopathy due to Ossified Ligamenta Flava in Lower Thoracic Region

Ⅰ．はじめに

　脊柱の支持組織の肥厚，骨化などにより脊髄や神経根が圧迫され，myelopathyやradiculopathyを現わす症例は頸椎・腰椎レベルでは珍しいことではない．

　1960年，月本^11）が頸椎後縦靱帯骨化に起因する脊髄障害をはじめて報告して以来，ことに本邦において本疾患の臨床症状，剖検所見，手術法に関する報告が多数認められる．また同年山口^13）が，胸椎黄靱帯骨化により脊髄症状を呈した症例を報告したが，この方はその後散発的な症例報告をみるにすぎず，必ずしも関心が深まったとはいいがたい．

Seven surgical cases of myelopathy due to narrow thoracic canal were reported and clinical analysis was made. Causes of canal stenosis were ossification of the ligamenta flava and hypertrophic pedicles. Four patients were female and two of them had diabetes mellitus. The rest of two female patients showed pathological response to 50g G.T.T. On the contrary, 3 male patients were all non diabetic. All of the female patients were proved to have ossified posterior longitudinal ligament of the cervical spine, however, none of the male patients showed similar abnormality in cervical spine X-rays.