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cervical_spondylosis_complications

Cervical spondylosis complications

Adjacent segment disease

Brown Séquard syndrome

Degenerative cervical myelopathy.

Cervical radiculopathy.

Paraplegia.

Tetraplegia.

Recurrent chest infection…


Cervical spondylosis (CS) may lead to distal brain damage affecting the white matter and gray matter of the sensorimotor cortex causing brain atrophy and functional adaptive changes 1).

It is reported to be associated with vertebrobasilar insufficiency. However, few cohort studies have investigated the association between CS and posterior circulation ischemic stroke.

The study cohort comprised 27,990 patients aged ≥18 years with a first diagnosis of CS. The controls consisted of patients with propensity score matched for age, sex, and comorbidities at a ratio of 1:1.

Lin et al. investigated the relationships of CS with ischemic stroke and all-cause mortality. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). The average follow-up duration was 6.13 (SD = 3.18) and 6.07 (SD = 3.19) years in the CS and non-CS cohorts, respectively.

The mean age of CS patients and non-CS patients was 54.9 ± 13.4 and 55.1 ± 14.9 years. Fifty-eight point five percent of CS patients and 59.2% of non-CS patients were women. CS patients were 1.46 folds more likely to develop a posterior circulation ischemic stroke (95% CI, 1.23-1.72) than non-CS patients. CS patients with myelopathy exhibited a 1.50-fold risk (95% CI, 1.21-1.86) of posterior circulation ischemic stroke compared with non-CS patients; CS patients without myelopathy were at a 1.43-fold risk (95% CI, 1.18-1.73) of posterior ischemic stroke compared with non-CS patients. The risk of posterior ischemic stroke was non-significant between non-CS patients and CS patients who had received spinal anterior decompression (adjusted HR, 1.66; 95% CI, 0.78-3.52), while receiving posterior decompression was associated with a 4.23-fold risk of posterior ischemic stroke (95% CI, 1.05-17.0).

This population-based study showed that CS is associated with an increased risk of posterior circulation ischemic stroke. Surgical posterior decompression was associated with the highest risk of posterior ischemic stroke 2).

References

1)
Bernabéu-Sanz Á, Mollá-Torró JV, López-Celada S, Moreno López P, Fernández-Jover E. MRI evidence of brain atrophy, white matter damage, and functional adaptive changes in patients with cervical spondylosis and prolonged spinal cord compression. Eur Radiol. 2019 Jul 26. doi: 10.1007/s00330-019-06352-z. [Epub ahead of print] PubMed PMID: 31350584.
2)
Lin SY, Lin CL, Chen DC, Lee HC, Chen HT, Lin TC, Hsu CY, Kao CH. Risk of posterior circulation stroke in patients with cervical spondylosis: A nationwide, population-based study. Atherosclerosis. 2018 Aug 17;277:42-46. doi: 10.1016/j.atherosclerosis.2018.08.006. [Epub ahead of print] PubMed PMID: 30172083.
cervical_spondylosis_complications.txt · Last modified: 2019/08/13 21:33 by administrador