頸部脊椎分離症—自験例と文献的考察

CERVICAL SPONDYLOLYSIS : A CASE REPORT AND REVIEW OF THE LITERATURE

　抄録　頸部脊椎分離症は非常にまれな疾患で，過去48例の文献的報告をみるのみである。われわれの経験例は，37歳男性で神経学的所見，頸部およびその他身体に外見上異常は認められなかったが，頸椎単純写，CT scanにて，両側C₆の関節突起間部に分離を，またC₆の上および下関節突起の低形成を認めた。またC₇の右上関節突起は代償性過形成のため上方偏位しており，C₆には潜在性脊椎破裂が存在していた。本疾患の病因は過去すべての例でその病歴，放射線学的所見より先天性説が有力とされており，本症例も同様であろうとわれわれも考えている。なお本症例も含めた49例（男性35例，女性14例）を検索するに，主訴としては，頸部痛，後頭部痛が35例と最多であった。分離の好発部位はC₆で38例であり，潜在性脊椎破裂は36例に合併していた。

Spondylolysis of the sixth cervical vertebrawas reported in a thirty-seven-year-old man. He complained of sleeplessness and had no history of trauma.

Plain cervical spine films and CT scan showed separation of the bilateral pars interarticularis and hypoplasia of the superior and inferior articular processes of C₆. And they showed com-pensated hyperplasia and upward deviation of the right superior articular process of C₇, but there was no instability of cervical vertebra.

Spina bifida occulta at C₆ and deviation of the spinous process of C₇ to the left side were obserbed clearly on CT scan.

We gave him no surgical treatment because of his normal neurological state and absence of instability.

Cervical spondylolysis is very rare disease, soonly 48 cases have been reported in literature. Our case is the first case that reports findings of CT scan.

Radiographic findings and the absence of history of trauma suggest a congenital etiology of this illness.

In the 49 patients including our case, 35 patients were males and 14 were females. 35 patients complained of neck and/or occipital pain, 12 of pain and/or sensory disturbance of upper extre-mities, and 8 of shoulder pain and/or stiffness. The prevalent site of involvement appears to be C₆ with only 14 cases involving another level, C₂, C₃, C₄ or C₅. 36 patients had spina bifida occulta and it was most frequently detected at the level of C₆.