Complex cervical spondylotic myelopathy: a report of two cases and literature review

Ma, Zhuo; Ma, Xun; Yang, Huilin; Feng, Hua; Chen, Chen

doi:10.1007/s00586-015-4038-3

Cited by 2 publications

(1 citation statement)

References 20 publications

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“…In general, the posterior approach is used to treat degeneration of multisegmental cervical vertebrae ( 17 ), as the anterior approach is technically challenging and may cause spinal cord damage. In the event of segmental instability, posterior lateral mass or pedicle screw fixation may be used ( 21 , 22 ). Although studies have reported patients who have clinically good outcomes with anterior segmental decompression with preservation of a portion of the posterior vertebral wall ( 23 , 24 ), the MRI and clinical observation of patients undergoing the posterior approach suggest that the spinal cord is also completely decompressed under the anterior approach.…”

Section: Discussionmentioning

confidence: 99%

Correlation of imaging characteristics of degenerative cervical myelopathy and the surgical approach with improvement for postoperative neck pain and neural function: a retrospective cohort study

Ma,

Ye,

et al. 2024

Quant Imaging Med Surg

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Background Complex degenerative cervical spondylotic myelopathy (DCM) is characterized by a variety of complex imaging features. The surgical method for DCM remains controversial. This study aimed to examine the correlation between the imaging characteristics of DCM with varying degrees of complexity and the surgical approach and clinical outcome. Methods A retrospective cohort study involving retrospective data collection was performed. A total of 139 patients with DCM who underwent surgery between January 2015 and January 2018 in the Orthopedics Department of Shanxi Bethune Hospital were divided into 3 groups according to the complexity of imaging features: 18 patients in the mild group, 66 patients in the moderate group, and 55 patients in the severe group. The Visual Analog Scale (VAS) and Japanese Orthopaedic Association (JOA) scores were used to compare the effects of neck pain and neural function prior to surgery according to the rate of improvement as of the last follow-up. Routine X-ray films were obtained at the follow-up of 3–6 months. The necessity of computed tomography (CT) and magnetic resonance imaging (MRI) examinations was determined based on clinical findings and X-ray images. Analysis of variance (ANOVA) was used to compare groups, the least significant difference (LSD) test was used for multiple comparisons, and the Chi-square test was used to compare classification indicators (imaging manifestations, gender), with P<0.05 being statistically significant. Binary logistic regression analysis was performed to determine the primary influencing factors of the JOA recovery rate. Results In all three groups, JOA and VAS scores at the final follow-up were significantly higher than those before surgery (P<0.001). There were significant differences in the preoperative VAS and JOA scores between any two groups, as well as in the VAS and JOA scores and improvement rates at the last follow-up between the mild group and the moderate group and between the mild group and the severe group (P<0.001). Age, preoperative JOA scores, MRI intramedullary hyperintensity signal, and the degree of spinal cord compression were primarily related to the nervous system recovery rate (P<0.001). Conclusions Age, MRI intramedullary hyperintensity signal, degree of spinal cord compression, and other variables were associated with the improvement of neural function in patients with DCM. Therefore, in addition to the JOA improvement rate or VAS score, additional factors, such as the patient’s condition, the improvement in quality of life, and the patient’s financial capacity, should be considered in evaluating the improvement of postoperative neck pain and neural function.

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Section: Discussionmentioning

confidence: 99%

Correlation of imaging characteristics of degenerative cervical myelopathy and the surgical approach with improvement for postoperative neck pain and neural function: a retrospective cohort study

Ma,

Ye,

et al. 2024

Quant Imaging Med Surg

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[Retracted] Characterization of Clinical Symptoms of Cervical Spondylotic Myelopathy Based on DKI Imaging Parameter Ratios

Tian

Zhang

Liu

et al. 2022

Contrast Media & Molecular Imaging

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In recent years, people’s living conditions have significantly improved, and their lifestyles have been diversified. However, the incidence of various diseases has also increased with it, including cervical spondylotic myelopathy (CSM). Spinal cord cervical spondylosis is one of the spinal cord compression disorders that can be severely disabling and accounts for 10% to 15% of all cervical spondylosis. In this paper, DKI image processing technology is used to study the symptoms of cervical spondylosis, which is helpful to help them explore the symptoms and causes. The onset of cervical spondylosis has a longer period of time, and the period of conservative treatment will inevitably require a longer period of time. The clinical symptoms of cervical spinal cord compression are mainly pain, and after the cervical spinal cord nerve is compressed, ischemia and hypoxia will occur, the nerve sensitivity will increase, and the patient will have reflex neck muscle pain symptoms. This causes degeneration of the patient’s intervertebral disc tissue, degeneration of facet joints, ossification of the posterior longitudinal ligament, and formation of spurs on the posterior edge of the vertebral body. The condition will become more complicated, so it is very important to identify the characteristics of the clinical symptoms of cervical spondylotic myelopathy to help patients with cervical spondylosis recover. This paper identifies the clinical symptoms of cervical spondylosis based on the parameter ratio method of Diffusional Kurtosis Imaging (DKI). The current state of diffusion kurtosis imaging and the treatment of cervical spondylosis and the treatment operation are introduced, and the image enhancement technology in medical imaging is used to analyze the disc herniation of each segment in the overflexion, neutral and hyperextension positions. After comparing the FA, MK, and MD values in the spinal cord between the normal group and the patient group, the results showed that the FA, MD and MK values in the patient group were lower than those in the normal group, and the findings showed that the MD and MK values were positively correlated with the JOA score, reflecting that as the clinical symptoms of spinal cervical spondylosis worsened. The size and number of cervical intervertebral disc bulge on the hyperextension image is obvious and the number increases (especially the C4/5, C5/6, and C6/7 intervertebral discs with greater mobility), and the highest is 0.82 and 27%, respectively.

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Complex cervical spondylotic myelopathy: a report of two cases and literature review

Cited by 2 publications

References 20 publications

Correlation of imaging characteristics of degenerative cervical myelopathy and the surgical approach with improvement for postoperative neck pain and neural function: a retrospective cohort study

Correlation of imaging characteristics of degenerative cervical myelopathy and the surgical approach with improvement for postoperative neck pain and neural function: a retrospective cohort study

[Retracted] Characterization of Clinical Symptoms of Cervical Spondylotic Myelopathy Based on DKI Imaging Parameter Ratios

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