Bilaterally symmetric cervical spondylotic amyotrophy: A novel presentation and review of the literature

Geberemichael, Sisay Gizaw; Johnston, James C.; Metaferia, Guta Zenebe; Wuhib, Mehila Z; Fernández, Hubert H.

doi:10.1016/j.jns.2009.12.009

Cited by 16 publications

(9 citation statements)

References 18 publications

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“…Moreover, we excluded CSA patients who had muscular atrophy or weakness of the bilateral upper extremities to avoid any confusion. 5 We retrospectively collected data from these patients with CSA regarding the age, sex, presence of diabetes mellitus, medication (vitamin B12), type of the most atrophic and impaired muscle (proximal type: impairment of the deltoid and biceps brachii muscles, distal type: impairment of the triceps, forearm and hand intrinsic muscles), MMT score of the muscles in the upper extremities at the time of presentation as determined by at least two authors, the presence of the pyramidal tract sign, the presence and number of T2 high signal intensity areas (T2 HIA) in the spinal cord were evaluated using axial and sagittal MRI by two authors (YI and HI), and the need for conversion to surgery after the observational follow-up. Moreover, we also collected data regarding the duration of symptoms before surgery and the type of surgery in patients who required conversion to surgical treatment.…”

Section: Methodsmentioning

confidence: 99%

Prognostic factors for cervical spondylotic amyotrophy: are signs of spinal cord involvement associated with the neurological prognosis?

Iizuka

Mieda

et al. 2014

Spinal Cord

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Objectives: The purpose of this study was to clarify the prognostic factors for cervical spondylotic amyotrophy (CSA). Methods: The authors retrospectively reviewed the medical records of 47 consecutive patients with CSA in whom the presence/ absence of the pyramidal tract sign was noted. We analyzed whether the age, sex, presence of diabetes mellitus, medication (vitamin B12), type of the most atrophic and impaired muscle, the muscle strength at the presentation, the presence of the pyramidal tract sign, magnetic resonance imaging (MRI) findings, including the presence and number of T2 high signal intensity areas (T2 HIA) in the spinal cord and the conversion to surgery were associated with the recovery of muscle strength in the patients. In addition, we also investigated whether the duration of symptoms before surgery and the type of surgery were associated with the recovery of muscle strength in patients who required conversion to surgical treatment. Results: The presence of T2 HIA on MRI (P ¼ 0.002), the number of T2 HIA on MRI (P ¼ 0.002) and conversion to surgery (P ¼ 0.015) were found to be significantly associated with a poorer recovery at the observational final follow-up. Further, the presence of the pyramidal tract sign (P ¼ 0.043) was significantly associated with a poor recovery at the final follow-up after surgery. Conclusion: The presence of a high signal intensity change on T2-weighted MRI and the pyramidal tract sign can be used as prognostic factors for patients with CSA.

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Section: Methodsmentioning

confidence: 99%

Prognostic factors for cervical spondylotic amyotrophy: are signs of spinal cord involvement associated with the neurological prognosis?

Iizuka

Mieda

et al. 2014

Spinal Cord

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“…Cervical spondylotic amyotrophy is usually reported as unilateral disorder, and occasionally, it presents as bilateral [15]. The age at onset of neurological symptom ranged from thirties to sixties, with men more frequently affected than women.…”

Section: Clinical Presentationmentioning

confidence: 99%

Cervical spondylotic amyotrophy

Jiang

Dai

2010

Eur Spine J

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Cervical spondylotic amyotrophy is characterized with weakness and wasting of upper limb muscles without sensory or lower limb involvement. Two different mechanisms have been proposed in the pathophysiology of cervical spondylotic amyotrophy. One is selective damage to the ventral root or the anterior horn, and the other is vascular insufficiency to the anterior horn cell. Cervical spondylotic amyotrophy is classified according to the most predominantly affected muscle groups as either proximaltype (scapular, deltoid, and biceps) or distal-type (triceps, forearm, and hand). Although cervical spondylotic amyotrophy always follows a self-limited course, it remains a great challenge for spine surgeons. Treatment of cervical spondylotic amyotrophy includes conservative and operative management. The methods of operative management for cervical spondylotic amyotrophy are still controversial. Anterior decompression and fusion or laminoplasty with or without foraminotomy is undertaken. Surgical outcomes of distal-type patients are inferior to those of proximal-type patients.

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“…The affected upper limb is usually unilateral but can occasionally be bilateral 3. In this study, two patients presented with bilateral muscle atrophy and six patients presented with shoulder girdle pain, which disappeared after surgery.…”

Section: Discussionmentioning

confidence: 57%

Evaluation of characteristics and surgical outcomes in cervical spondylotic amyotrophy

Wang

Jiang

et al. 2014

IJOO

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Background:Cervical spondylotic amyotrophy (CSA) is a rare clinical syndrome resulting from cervical spondylosis. Surgical treatment includes anterior cervical decompression and fusion (ACDF), and laminoplasty with or without foraminotomy. Some studies indicate that ACDF is an effective method for treating CSA because anterior decompression with or without medial foraminotomy can completely eliminate anterior and/or anterolateral lesions. We retrospectively evaluated outcome of surgical outcome by anterior cervical decompression and fusion (ACDF).Materials and Methods:28 CSA patients, among whom 12 had proximal type CSA and 16 had distal type CSA, treated by ACDF, were evaluated clinicoradiologically. The improvement in atrophic muscle power was assessed by manual muscle testing (MMT) and the recovery rate of the patients was determined on the basis of the Japanese Orthopedic Association (JOA) scores. Patient satisfaction was also examined.Results:The percentage of patients, who gained 1 or more grades of muscle power improvement, as determined by MMT, was 91.7% for those with proximal type CSA and 37.5% for those with distal type CSA (P < 0.01). The JOA score-based recovery rates of patients with proximal type and distal type CSA were 60.8% and 41.8%, respectively (P < 0.05). Patient satisfaction was 8.2 for those with proximal type CSA and 6.9 for those with distal type CSA (P < 0.01). A correlation was observed among the levels of improvement in muscle power, JOA score based recovery rate, patient satisfaction and course of disease (P < 0.05).Conclusion:ACDF can effectively improve the clinical function of patients with CSA and result in good patient satisfaction despite the surgical outcomes for distal type CSA being inferior to those for proximal type CSA. Course of disease is the fundamental factor that affects the surgical outcomes for CSA. We recommend that patients with CSA undergo surgical intervention as early as possible.

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Bilaterally symmetric cervical spondylotic amyotrophy: A novel presentation and review of the literature

Cited by 16 publications

References 18 publications

Prognostic factors for cervical spondylotic amyotrophy: are signs of spinal cord involvement associated with the neurological prognosis?

Prognostic factors for cervical spondylotic amyotrophy: are signs of spinal cord involvement associated with the neurological prognosis?

Cervical spondylotic amyotrophy

Evaluation of characteristics and surgical outcomes in cervical spondylotic amyotrophy

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