Cervical Spondylotic Myelopathy Caused by Single-Level Vertebral Spontaneous Fusion

Abstract

PurposeTo evaluate the clinical features, imaging characteristics, surgical options, and clinical outcomes of patients with Cervical spondylotic myelopathy (CSM) caused by single-level vertebral spontaneous fusion (SLVSF).MethodsSixteen consecutive patients with SLVSF who underwent anterior surgery were included in this study and 38 patients with CSM caused by spinal degeneration were enrolled as a control group. Demographic features, clinical presentations, imaging characteristics, surgery strategy, Nurick grade, Japanese Orthopedic Association (JOA) score, neck disability index (NDI), and complications were evaluated.ResultsThere were significant differences between the two groups in the mean age and the average duration of neck pain. There was no significant difference between the two groups in length of cervical spine. In the SLVSF group, 13 patients had upper segment translational instability and none had rotational instability. Pre- and postoperative Nurick grades were 2.94±0.77 and 2.19±0.54 in the SLVSF group, and 2.97±0.72 and 2.16±0.64 in the control group. Pre- and postoperative JOA scores were 9.25±2.02 and 11.69±1.62 in the SLVSF group, and 9.87±2.58 and 12.53±2.69 in the control group. Pre- and postoperative NDI values were 28.5±7.75 and 15.56±5.51 in the SLVSF group, and 16±6.13 and 11.29±4.58 in the control group.ConclusionsPatients with SLVSF have necks of normal lengths, which can be used to distinguish this disorder from Klippel-Feil syndrome. There are three main features of SLVSF: (1) hypoplasia at both of the spontaneously fused vertebral bodies; (2) a major pathological feature of translational instability of the upper vertebra to the fused level; and (3) severe neck pain. Anterior surgery has a good therapeutic effect for patients with cervical SLVSF.

Cervicothoracic Arachnoid Cyst Causing Cervical Myelopathy: A Case Report

“…Advanced age related acquired quadriparesis is the most common reason for cervical spondylotic myelopathy. Cervical spondylotic myelopathy is a clinical condition resulting from constriction and insufficient nutrition dependent on damage which occurs in white and gray matter as a result of solitary or combined pathologies of the anterior, medial and posterior spinal cord such as posterior longitudinal ligament ossification, disc degeneration, facet joint hypertrophy or ligamentum flavum hypertrophy [ 2 , 14 - 16 ]. Spondylosis is shown to be an etiological factor, especially for the development of arachnoid cysts.…”

Cervical corpectomy for sub-axial retro-vertebral body lesions

“…Neck Disability Index (NDI) [10,11] which is a modification of Oswestry Disability Index (ODI) was used to evaluate all patients, pre-and post-operatively. The ODI was scored on a scale from 0 to 100 using the Oswestry Disability Questionnaire of 10 items (personal care, lifting objects, sitting, standing, walking, sleeping, sex life, social life, traveling, and need for medications).…”

Fresh frozen cortical strut allograft in two-level anterior cervical corpectomy and fusion

“…Clinical evaluation consisted of medical history and physical examination. The clinical results were assessed using the Japanese Orthopaedic Association (JOA) scoring system [ 20 ], Nurick score [ 20 ], visual analog scale (VAS) for neck pain, and neck disability index (NDI) [ 21 ]. At the last follow-up, clinical examination was assessed by the JOA scoring system.…”