高齢者に発症した環椎低形成による脊椎管狭窄症の1手術例

A Surgical Case of Cervical Canal Stenosis Caused by Atlas Hypoplasia in an Elderly Patient

I．はじめに

　頭蓋骨頸椎移行部には先天奇形も多く，環軸椎亜脱臼，頭蓋底陥入など種々の疾患で脊髄神経障害を来たす．しかしながら環椎低形成単独で神経症状を呈することは非常に稀であり，さらに高齢者発症例は見当たらない．今回われわれは，環椎低形成による高位頸髄症状を呈し，手術療法を行った高齢者例を経験したので報告する．

We report an 81-year-old man with hypoplastic atlas resulting in a severe stiff feeling in the bilateralshoulders, spastic tetraparesis, and hypesthesia below the C2 segment level of the spinal cord. These symp-toms are compatible with compression of the high cervical cord. Neuroimaging studies revealed a narrow-ing of the spinal cord by compression of the hypoplastic atlas. Laminoplasty of the atlas was performedunder general anesthesia, and the patient's symptoms were resolved. Operated cases of older patient's withatlas hypoplasia have been rarely reported. Laminoplasty of the atlas is a safe and useful procedure forhigh cervical compression due to hypoplastic atlas.