论文信息 - A Case of Closed Wedge Vertebral Osteotomy for Kyphosis in Ankylosing Spondylitis

A Case of Closed Wedge Vertebral Osteotomy for Kyphosis in Ankylosing Spondylitis

強直性脊椎炎に伴う後弯変形に対して矯正骨切り術（closed wedge vertebral osteotomy）を施行した一例を報告する．症例は49才男性．25才時に強直性脊椎炎と診断され，42才時に前医にて腰痛・神経痛に対し除圧固定術（L4-S1）を施行された．その直後にL2圧迫骨折を生じ，徐々に腰痛は増悪し後弯変形のために前方水平視が困難となってきた．47才時に当科を初診．腰痛のため5分以上の立位保持が不能であり，全脊椎の可動性は消失し，前方水平視は不可能であった．本症例に対してL2椎体矯正骨切り術・後方固定術（T8-S1）を施行した．術後，歩容は著しく改善し，前方水平視が可能となった．X線上L1-L3の後弯角は39°から前弯10°へと49°の矯正を認めた．またChin-brow to vertical angleは術前45°から術後8°へと改善した．Closed wedge vertebral osteotomyは，楔状に椎体の骨切りを行い椎体前方は開大せずに後方を短縮させる方法である．重篤な合併症である大血管損傷が生じにくい利点を有し，比較的安全な方法であると考えられた．

K. Harimaya | Y. Iwamoto | T. Doi | Y. Matsumoto | Toru Asakura

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