Segmental instability in cervical spondylotic myelopathy with severe disc degeneration
Segmental instability in cervical spondylotic myelopathy with severe disc degeneration
From: Spine. 2006 May 20;31(12):1327-31
A retrospective study was conducted to investigate relationships between severe disc degeneration and segmental instability in cervical spondylotic myelopathy and to discuss surgical treatment for cervical spondylotic myelopathy with severe disc degeneration. Information on relationships between segmental instability and spinal cord compression in cervical spondylotic myelopathy with severe disc degeneration is scarce. Radiographs and magnetic resonance images of patients with cervical spondylotic myelopathy with (n = 42) and without (n = 75) severe disc degeneration were reviewed retrospectively. Cervical instability and spinal cord compression factors were analyzed. Outcomes of anterior cervical decompression and fusion and expansive laminoplasty were evaluated in medical records of follow-up clinics.
Segmental instability was found in 71.4% of patients with severe disc degeneration and 22.7% of patients without severe disc degeneration. Spinal cord compression was found at the intervertebral space of severe disc degeneration and upper adjacent disc space. The recovery rate of anterior cervical decompression and fusion and expansive laminoplasty was 60.8% and 57.1%, respectively. The upper adjacent vertebra above severe disc degeneration has inclination of segmental instability. There is static spinal cord compression in intervertebral spaces of severe disc degeneration and dynamic compression in upper adjacent intervertebral spaces. Multilevel anterior cervical decompression and fusion or expansive laminoplasty should be used for surgical treatment.
