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cervical_degenerative_disc_disease_clinical_features

Cervical Degenerative Disc Disease Clinical Features

Cervical spondylosis may produce several types of clinical problems 1).

1. Myeloradiculopathy

a. Some combination of radiculopathy

b. Spinal cord compression may cause myelopathy.

Syndromes

Transverse lesion syndrome

Motor system syndrome

Central cord syndrome

Brown Sequard syndrome

Brachialgia and cord syndrome

2. Pain and paresthesias in the head, neck and shoulders with little or no suggestion of radiculopathy nor abnormal physical findings. This group is the most difficult to diagnose and treat, and often requires a good physician-patient relationship to decide if surgical treatment should be undertaken in an attempt to provide relief.

Cervical spondylosis is the most common cause of myelopathy in patients > 55 yrs of age 2) , Cervical spondylotic myelopathy is rare in patients < 40 years of age.

Cervical spondylotic myelopathy develops in almost all patients with ≥ 30 % narrowing of the cross sectional area of the cervical spinal canal 3) (although some patients with more severe cord compression do not have myelopathy 4) 5))

1)
Mayfield FH (1966) Cervical spondylosis: a comparison of the anterior and posterior approaches. Clin Neurosurg 13:181–187.
2)
Cooper, PR. Cervical spondylotic myelopathy. Contemp Neurosurg. 1997;19(25):1–7
3)
Yu YL, du Boulay GH, Stevens JM, Kendall BE. Computed tomography in cervical spondylotic myelopathy and radiculopathy: visualisation of structures, myelographic comparison, cord measurements and clinical utility. Neuroradiology. 1986;28(3):221-36. PubMed PMID: 3014373.
4)
Epstein JA, Marc JA, Hyman RA, Khan A, Mardayat M. Total myelography in the evaluation of lumbar discs. With the presentation of three cases of thoracic neoplasms simulating nerve root lesions. Spine (Phila Pa 1976). 1979 Mar-Apr;4(2):121-8. PubMed PMID: 264028.
5)
Houser OW, Onofrio BM, Miller GM, Folger WN, Smith PL. Cervical spondylotic stenosis and myelopathy: evaluation with computed tomographic myelography. Mayo Clin Proc. 1994 Jun;69(6):557-63. PubMed PMID: 8189762.
cervical_degenerative_disc_disease_clinical_features.txt · Last modified: 2018/04/16 13:45 by administrador