頸椎椎間板ヘルニアの外科的療法—200例の経験からみた術式決定についての一考察

Surgical Treatment of the Cervical Herniated Disc: A consideration of the choice of the operative methods foilowing our experience of 200 patients

I．はじめに

　脊椎の疾患に原因する脊髄症をすべて骨軟骨症性脊髄症（spondylotic myelopathy）と総称することは適切でなく，リウマチ性脊椎炎，脊椎の先天異常，外傷，軟性椎間板ヘルニアおよび腫瘍，あるいは後縦靱帯骨化症などはそれぞれ固有の病名で表現すべきである^6）．

　頸部脊髄症の外科的療法について論じた文献は枚挙にいとまがないが^23,36,38），著者により対象とした疾患が任意に定義されている感があり，種々の術式を同一平面で議論することには無理があると考えられる．

There is a controversy on the surgical treatment for the so-called cervical herniated disc. Recently operators choicing the anterior approach have in-creased in more and more. However, considering the historical view of the treatment of disc disease, it is obvious that the posterior approach is also an important method, especially in the cases combined with the stenotic cervical spinal canal.

During the past five years 200 patients of cervical herniated disc disease were operated in our clinic by using our newly deviced instruments and new materials.