Atypical symptoms in patients with cervical spondylosis: Comparison of the treatment effect of different surgical approaches

Yuqing Sun, Aikeremujiang Muheremu, Wei Tian, Yuqing Sun, Aikeremujiang Muheremu, Wei Tian

Abstract

To compare the effectiveness of total disk replacement (TDR), anterior cervical discectomy and fusion (ACDF), and laminoplasty on atypical symptoms of cervical spondylosis.Patients with confirmed diagnosis of cervical spondylosis and reported atypical symptoms such as blurred vision, headache, nausea, palpitation, tinnitus, vertigo, hypomnesia, and abdominal discomfort were retrospectively included in the present study. They were treated with TDR, ACDF, or laminoplasty depending on the etiology and patient preference. Severity of the atypical symptoms before the surgery and at the end of 2-year follow-up was recorded and the degree of severity alleviation was compared between different surgical approaches.A total number of 336 patients who were treated in our institute from February 2002 to March 2011 were included in the final analysis. Atypical symptoms were significantly alleviated in most patients after surgical intervention. No significant differences were found regarding the change of severity of those symptoms among patients in different surgery groups.TDR, ACDF, and laminoplasty can equally alleviate the severity of atypical symptoms in patients with cervical spondylosis. This indicates that the neural network in the posterior longitudinal ligament may not be the cause of atypical symptoms in patients with cervical spondylosis.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

References

    1. Morio Y, Teshima R, Nagashima H, et al. Correlation between operative outcomes of cervical compression myelopathy and MRI of the spinal cord. Spine 2001;26:1238–45.
    1. Matsumoto M, Toyama Y, Ishikawa M, et al. Increased signal intensity of spinal cord on magnetic resonance images in cervical compressive myelopathy. Spine 2000;25:677–82.
    1. Bohlman HH, Emery SE, Goodfellow DB, et al. Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy: long-term follow-up of one hundred and twenty-two patients. J Bone Joint Surg Am 1993;75:1298–307.
    1. Chagas H, Domingues F, Aversa A, et al. Cervical spondylotic myelopathy: 10 years of prospective outcome analysis of anterior decompression and fusion. Surg Neurol 2005;64suppl 1:S30–5.
    1. Yue WM, Brodner W, Highland TR. Long-term results after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year radiologic and clinical follow-up study. Spine (Phila Pa 1976) 2005;30:2138–44.
    1. Rajasekaran S, Thomas A, Kanna RM, et al. Lumbar spinous process splitting decompression provides equivalent outcomes to conventional midline decompression in degenerative lumbar canal stenosis. Spine (Phila Pa 1976) 2013;38:1737–43.
    1. Yuan W, Zhu Y, Liu X, et al. Laminoplasty versus skip laminectomy for the treatment of multilevel cervical spondylotic myelopathy: a systematic review. Arch Orthop Trauma Surg 2014;134:1–7.
    1. Kim CH, Chung CK, Kim K-J, et al. Cervical extension magnetic resonance imaging in evaluating cervical spondylotic myelopathy. Acta Neurochir 2014;156:259–66.
    1. Vavasour IM, Meyers SM, MacMillan EL, et al. Increased spinal cord movements in cervical spondylotic myelopathy. Spine J 2014;14:2344–54.
    1. Endo K, Ichimaru K, Komagata M, et al. Cervical dizziness and dizziness after whiplash injury. Eur Spine J 2006;15:886–90.
    1. Foster CA, Jabbour P. Barre-Lieou syndrome and the problem of the obsolete eponym. J Laryngol Otol 2007;121:680–3.
    1. Serre H, Labauge R, Simon L, et al. Barré-Liéou syndrome, designated “posterior sympathetic cervical syndrome”. Rheumatologie 1969;21:217–46.
    1. Pearce JM. Barre-Lieou “syndrome”. J Neurol Neurosurg Psychiatry 2004;75:319.
    1. Strek P, Reron E, Maga P, et al. A possible correlation between vertebral artery insufficiency and degenerative changes in the cervical spine. Eur Arch Otorhinolaryngol 1998;255:437–40.
    1. Brandt T, Bronstein AM. Cervical vertigo. J Neurol Neurosurg Psychiatry 2001;71:8–12.
    1. Ito Y, Tanaka N, Fujimoto Y, et al. Cervical angina caused by atlantoaxial instability. J Spinal Disord Tech 2004;17:462–5.
    1. Qian J, Tian Y, Qiu GX, et al. Dynamic radiographic analysis of sympathetic cervical spondylotic myelopathy instability. Chin Med Sci J 2009;24:46–9.
    1. Vinchon M, Assaker R, Leclerc X, et al. Vertebrobasilar insufficiency resulting from traumatic atlantoaxial instability: case report. Neurosurgery 1995;36:839–41.
    1. Wang Z, Wang X, Yuan W, et al. Degenerative pathological irritations to cervical PLL may play a role in presenting sympathetic symptoms. J Med Hypotheses 2011;77:921–3.
    1. Gu1 Q, Jiang D, Wang X, et al. Chronic compression of the posterior longitudinal ligament of the cervical spine is associated with abnormal discharge of middle cervical ganglion. Int J Clin Exp Med 2014;7:4316–21.
    1. Xue R, Shen Y, Wang L, et al. Early clinical effect of resecting posterior longitudinal ligament in anterior approach for cervical spondylotic myelopathy with sympathetic symptoms. Chin J Orthop 2013;33:105–10.
    1. Li J, Jiang D-J, Wang X-W, et al. Mid-term outcomes of anterior cervical fusion for cervical spondylosis with sympathetic symptoms. J Spinal Disord Tech 2016;29:255–60.
    1. Wang X, Gu T, Yuan W, et al. Treatment and mechanism of cervical spondylosis with sympathetic symptoms. Chin J Surg 2008;46:1424–7.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa