[Clinical diagnosis and management of cervical spondylotic amyotrophy]

Zhonghua Yi Xue Za Zhi. 2017 May 9;97(17):1320-1323. doi: 10.3760/cma.j.issn.0376-2491.2017.17.010.
[Article in Chinese]

Abstract

Objective: To investigate the clinical characteristics and surgical treatment of cervical spondylotic amyotrophy. Methods: Thirteen patients(13 man) with proximal (10) and distal(3) cervical spondylotic amyotrophy between November 2014 and September 2016 were included in this study. The average age of the patients was 55 (range, 47-66) years. The sex, age, clinical course, type of amyotrophy, lesion segment and postdecompression improvement in muscle power were reviewed. Results: Of 13 cervical spondylotic amyotrophy patients, 9 were performed on with cervical disectomy, 2 were performed on with cervical posterior operation, 2 remainding patients received nonoperative treatment. Cervical spondylotic amyotrophy patients were followed up 6-22 (average 10.6) months, muscle power of 4 patients (all proximal-type)were improved completely (the average recovery time were 4.4 months), muscle power of 6 patients were improved uncompletely, 1 patients failed to improve, the 2 remainding patients received nonoperative treatment had no change. Conclusion: Cervical spondylotic amyotrophy as a rare type of cervical spondylotic disorder, It should distinguish cervical spondylotic amyotrophy from amyotrophic lateral sclerosis, especially in the early stage of amyotrophic lateral sclerosis. A surgical treatment is recommended as the first line of proximal-type CSA, especially those with serious compression. It is important that clinicians should be aware that distal-type CSA had a poor results, resulting in a lower lower satisfaction, especially those with no, or insignificant, sensory disturbance.

目的: 探讨肌萎缩型颈椎病的临床特征及手术治疗效果。 方法: 回顾性分析2014年11月至2016年9月在第二军医大学第二附属医院长征医院脊柱外科就诊并被诊断为肌萎缩型颈椎病13例,均为男性;近端型患者10例,远端型3例;手术前后采用徒手肌力试验(MMT)方法对患者肌力进行评估。 结果: 13例患者术后均获得随访,平均随访时间10.6(6~22)个月。9例患者接受了颈前路减压植骨融合内固定术,2例患者接受了颈后路减压内固定术,2例患者采用保守治疗。4例患者肌力获得完全恢复;6例患者术后肌力有所改善;1例患者术后肌力改善不明显;2例未手术者肌力未发生明显改变。 结论: 肌萎缩型颈椎病发病率较低,需同肌萎缩性侧索硬化症等运动神经元疾病相鉴别。对于压迫严重的近端型肌萎缩型颈椎病患者应早期手术治疗;对于不伴有上肢感觉异常的远端型患者,术后肌萎缩恢复相对较差,患者满意度较低,手术治疗选择宜慎重。.

Keywords: Cervical spondylosis; Cervical vertebrae; Muscular atrophy; Surgery.

MeSH terms

  • Aged
  • Amyotrophic Lateral Sclerosis / diagnosis
  • Cervical Vertebrae
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscular Atrophy
  • Muscular Atrophy, Spinal* / diagnosis
  • Muscular Atrophy, Spinal* / therapy
  • Spondylosis
  • Treatment Outcome