前方除圧のみにより消失した外傷性脊髄空洞症の1例—脊髄空洞症の外科治療に関する示唆

A Case of Traumatic Syringomyelia which Disappeared after Anterior Decompression: A suggestion for surgical treatment of syringomyelia

I．はじめに

　脊髄空洞症の外科的治療法に関しては種々の方法があり意見の一致を見るにいたっていないのが現状である．20年前に頸髄損傷を受け，最近になり神経学的悪化をきたした患者について精査したところ，C₅椎体の脱臼骨折による頸髄の著明な圧迫所見に加えその部より上位（C₅—C₂）に脊髄空洞症を合併していた．この患者に対し，前方除圧術を施行したところ，syrinxの消失と神経学的改善が認められたので，その詳細を報告するとともにその治療法について若干の考察を加える．

A 37-year-old man had received cervical spinal-cord injury 20 years previously. Recently, he complained of progressive spastic gait and was shown to have frac-ture dislocation of the C5 vertebral body which com-pressed the spinal cord posteriorly. He also had a syrinx from the C5 to C2 vertebral level. Postoperative-ly, this syrinx disappeared after anterior decompression of the C4 and C5 vertebral bodies. Such a case as this has never been reported, and this case may give a sug-gestion for surgical treatment of syringomyelia, because it is very natural that the most reasonable treatment of any disease is removal of the cause.