頚椎変性疾患のバリエーション—診断におけるポイントは？

Variations in Cervical Degenerative Diseases:What are the Key-points in Diagnosis?

Point

・頚椎変性疾患は複数の病態が知られているが，1人の患者に併存していることも多い．

・頚椎変性疾患は放射線画像で指摘されても実際は無症候性である病変も多く，注意を要する．

・頚椎変性疾患の診断・治療において重要なのは，病名診断ではなく障害を引き起こしている現象を同定することである．

・そのためには，神経症状の種類や範囲，神経圧迫の機序ならびに不安定性の有無などに着目する姿勢が重要である．

　Degenerative cervical spine diseases are caused by age-related changes in the spine and often lead to impairment of neurological function, resulting in reduced quality of life. Multiple cervical spine degenerative diseases are known, such as cervical spondylosis, cervical disc herniation, and ossification of the posterior longitudinal ligament, which often coexist in a single patient. In degenerative cervical spine disease, many lesions are noted on radiographs but are often asymptomatic; hence, caution is required in clinical practice. Therefore, for the treatment of the disease, it is important to diagnose and identify the phenomenon or location causing the disorder. For this purpose, it is important to focus on the type and extent of neurological symptoms; mechanism of nerve compression, radiculopathy or myelopathy; and presence or absence of spinal instability, static or dynamic.