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Muscle Weakness-Related Spinal Instability Is the Cause of Cervical Spinal Degeneration and Spinal Stabilization Is the Treatment: An Experience with 215 Cases Surgically Treated over 7 Years.
- Source :
-
World neurosurgery [World Neurosurg] 2020 Aug; Vol. 140, pp. 614-621. - Publication Year :
- 2020
-
Abstract
- Background: The rationale of only fixation without any kind of bone, ligament, disc, or osteophyte decompression as a treatment for single- or multiple-level cervical spinal degeneration was analyzed. The concept was based on the understanding that muscle weakness-related spinal instability is the cause of spinal degeneration, and spinal stabilization is the treatment.<br />Materials and Methods: During the period June 2012 to June 2019, 215 patients with single- or multiple-level cervical spinal degeneration who presented with symptoms of radiculopathy and/or myelopathy were treated. Age range of patients was 35-76 years. The series included 194 men and 21 women. Patients with acute symptoms and disc herniation, prolapse, or extrusion were excluded from the analysis. Only spinal stabilization by deploying facet screw fixation techniques was done in all cases. No decompression by resection of any bone, soft tissue, disc, or osteophyte was done. The minimum follow-up was 6 months.<br />Results: Postoperative clinical outcome was measured using Japanese Orthopaedic Association score, Goel clinical grade, and visual analog scale score. In addition, 2 specialist neurosurgeons were recruited to assess clinical outcome. Clinical assessments and videos were used to document the outcome. There were no significant complications. Varying degree of clinical recovery was seen in all patients. None of the patients in the series underwent reoperation for persistence or recurrence of symptoms.<br />Conclusions: Instability of spinal segments forms the basis of spinal degeneration. Stabilization forms the basis of surgical treatment. The role of decompression needs to be re-evaluated.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Back Muscles physiopathology
Bone Screws
Female
Humans
Joint Instability complications
Joint Instability physiopathology
Magnetic Resonance Imaging
Male
Middle Aged
Muscle Weakness complications
Muscle Weakness physiopathology
Neck Muscles physiopathology
Radiculopathy etiology
Radiculopathy physiopathology
Retrospective Studies
Spinal Cord Compression etiology
Spinal Cord Compression physiopathology
Spondylosis etiology
Spondylosis physiopathology
Treatment Outcome
Atlanto-Axial Joint surgery
Cervical Vertebrae surgery
Joint Instability surgery
Radiculopathy surgery
Spinal Cord Compression surgery
Spinal Fusion
Spondylosis surgery
Zygapophyseal Joint surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1878-8769
- Volume :
- 140
- Database :
- MEDLINE
- Journal :
- World neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 32797990
- Full Text :
- https://doi.org/10.1016/j.wneu.2020.03.104