Microsurgical anterior foraminodiscectomy was developed to improve the surgical result of cervical radiculopathy. We reviewed 40 patients with cervical spondylosis after anterior foraminodiscectomy with or without bony fusion over 5 years. The tunnel of anterior foraminodiscectomy was made at lateral one-third of the disc trajectory to intersect the uncinate process at the level of neuroforamen. The compressed nerve root and spinal cord were decompressed by removing the spondylotic spur and disc. The most common presenting symtom was radiating pain to upper extremity. The most frequent site of involvement was the C5-6. Operation of one level was performed in 57% of cases, 2 levels in 40% of cases and three levels in 3%. Of the 40 cases, interbody fusion was performed in 45% of cases. In 92.5% of the patient, the outcome was excellent or good based on Odom's criteria. Postoperative complications were encountered in 7.5%. The correlation between the clinical factors and postoperative results was assessed. As to age, duration of symtoms, herniation of soft and hard disc, number of the operative levels and with and without bony fusion, the clinical results were not stastistically significant.
Humans ; Postoperative Complications ; Radiculopathy ; Spinal Cord ; Spondylosis* ; Upper Extremity

Adult ; Cervical Vertebrae ; Humans ; Hyperesthesia ; etiology ; Male ; Spondylosis ; complications

Acupuncture Therapy ; Adult ; Aged ; Heart Diseases ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Spondylosis ; complications

OBJECTIVE: The purpose of this study is to evaluate the efficacy and safety of 3-level hybrid surgery (HS), which combines fusion and cervical disc replacement (CDR), compared to 3-level fusionin patient with cervical spondylosis involving 3 levels. METHODS: Patients in the anterior cervical discectomy and fusion (ACDF) group (n=30) underwent 3-level fusion and the HS group (n=19) underwent combined surgery with fusion and CDR. Clinical outcomes were evaluated using the visual analogue scale for the arm, the neck disability index (NDI), Odom criteria and postoperative complications. The cervical range of motion (ROM), fusion rate and adjacent segments degeneration were assessed with radiographs. RESULTS: Significant improvements in arm pain relief and functional outcome were observed in ACDF and HS group. The NDI in the HS group showed better improvement 6 months after surgery than that of the ACDF group. The ACDF group had a lower fusion rate, higher incidence of device related complications and radiological changes in adjacent segments compared with the HS group. The better recovery of cervical ROM was observed in HS group. However, that of the ACDF group was significantly decreased and did not recover. CONCLUSION: The HS group was better than the ACDF group in terms of NDI, cervical ROM, fusion rate, incidence of postoperative complications and adjacent segment degeneration.
Arm ; Arthroplasty ; Diskectomy* ; Humans ; Incidence ; Neck ; Postoperative Complications ; Range of Motion, Articular ; Spondylosis ; Total Disc Replacement*

The patient was treated as pharyngeal foreign body sensation for six months. Laryngeal endoscopy: one about 1 cm x 2 cm x 2 cm, hard, smooth bulge in hypopharyngeal wall at the plane of epiglottis valley. The cervical MRI showed that the C3-C4 disc herniation and degeneration of the C3-C4 vertebrae. Cervical CT showed the C3-C4 disc osteophyte formation and forward bulge. After orthopedic consultation, the patient was diagnosed as esophageal cervical spondylosis. C3-C4 diskectomy and vertebral interbody bone grafted with plate fixation were undertaken. At postoperational day 2, the pharyngeal foreign body sensation disappeared.
Adult ; Cervical Vertebrae ; Foreign Bodies ; diagnosis ; etiology ; Humans ; Male ; Pharyngitis ; diagnosis ; etiology ; Spondylosis ; complications ; diagnosis

Aged ; Esophagus ; Humans ; Hyperostosis, Diffuse Idiopathic Skeletal ; complications ; diagnostic imaging ; physiopathology ; surgery ; Male ; Spondylosis ; complications ; Tomography, X-Ray Computed

Cervical disc disease and spondylosis have troubled human beings since the earliest recording of human ailment, encountered in term of one's life and still is one of the most intricated neurosurgical disorders, although there are a good many kind of diagnostic and surgical advances. Cervical disc disease has been studied more extensively and also diagnostic studies have developed considerably in recent times including myelography, computerized tomographic scan and magnetic resonance imaging. The treatment for cervical disc disease may be medical, surgical, or both but surgery, is increasingly popular owing to development of microanatomy, pathology, diagnostic tools and microsurgery. The surgical approaches to cervical disc disease have developed as the clinical syndrome, mechanisms of disease, and pathological changes that ensue have been better defined. Dramatic result of posterior decompressive laminectomy was reported by Horsley in 1901 and modified by Scoville, Kahn, Fager, and others. The anterior approach to compressive lesions, a more recent development by Robinson in 1955, by Cloward in 1958, and Boldrey, has become increasingly popular. The anterolateral approach, offered by Verbiest in 1968, provided an third avenue to the pathological cervical disc disease. Surgical results for cervical root compression can be relieved well, but myelopathy responds less well to decompression, provided the preoperative diagnosis is accurate and the operation is done carefully from either anterior or posterior approach. The authors has reviewed 79 cases cervical disc disease which treated surgically in Kyung Hee Medical Center from March, 1984 to May, 1990, the result as follows: 1) Cervical disc disease were more frequently encountered between 5th and 6th decades(67%) and the ratio of male to female was 2:1. 2) The symptom onset was acute in 58% of patients but the causes could not define clearly in 76% of patients. 3) The most frequent clinical symptom was pain in the neck(88.6%). 4) The most frequent site of disc herniation was C5-6 level as a single lesion, but the multiple level was effected in 12.7% of patients. 5) Postoperative complications were occurred in 11.4% of patients. 6) The prognosis was influenced by age, sex, time interval between the symptom onset and operation, and direction and character of disc herniation.
Decompression ; Diagnosis ; Female ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Male ; Microsurgery ; Myelography ; Pathology ; Postoperative Complications ; Prognosis ; Spinal Cord Diseases ; Spondylosis

Adult ; Female ; Humans ; Magnetic Resonance Imaging ; Methylprednisolone ; therapeutic use ; Neuromyelitis Optica ; diagnosis ; drug therapy ; etiology ; Spondylosis ; complications ; diagnosis ; drug therapy

OBJECTIVETo investigate the application of the expanding forming under the plate through cervical spatium intermusculare approach to treat multi-segmental myelopathic cervical spondylosis.

METHODSFrom July 2005 to June 2013, 25 patients with multi-segmental myelopathic cervical spondylosis were treated by the expanding forming under the plate through cervical spatium intermusculare approach including 16 males and 9 females with an average age of 56.5 years old ranging from 35 to 78 years old. Among them, 10 cases were onset without causes slowly, 7 cases were onset without causes suddenly, 8 cases were onset after mild trauma or tired. JOA scoring, incidence of postoperative axial symptoms and imaging studies were used to evaluate the effect.

RESULTSTwenty-five cases were followed up for 6 months to 7 years and 6 months with an average of 2 years and 9 months. There were no infection, cerebrospinal fluid leakage after the operation, and complications such as nerve damage were occurred. The operation time was 120 to 150 min, the bleeding was 300 to 500 ml. Imaging examination showed vertebral canal sagittal diameter increased, the vertebral canal increased significantly in the cross sectional area of the spinal cord, cervical curvature was straighten in 4 cases (2 cases of them became normal sequence). There were no more cases of cervical protruding and segmental instability increased. Postoperative walking ability enhanced, the finger activity of majority of patients improved on flexibility, grip strength, and accuracy of using chopsticks improved, numbness and chest waist band feeling had different degree of reduce, preoperative urine impairment were improved to varying degrees. Preoperative JOA scores were 3 to 13 points with an average of (8.86 ± 4.25) points; Postoperative 12 months' JOA scores were 7 to 17 points with an average of (13.76 ± 3.56) points, period was 60.19% in average, JOA score had statistically difference between before and after operation (P < 0.05). The result were excellent in 14 cases, good in 6 cases, and fair in 4 cases and poor in 1 case.

CONCLUSIONApplication of the expanding forming under the plate through cervical spatium intermusculare approach to treat multi-segmental myelopathic cervical spondylosis, through muscular clearance, can retain complete cervical back muscle, maintain stability of cervical spine, and vertebral canal can get effective decompression at the same time.

Adult ; Aged ; Bone Plates ; Cervical Vertebrae ; Female ; Humans ; Laminectomy ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Spondylosis ; surgery

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Radiculopathy ; etiology ; physiopathology ; therapy ; Spondylosis ; complications ; Upper Extremity ; physiopathology