• World Neurosurg · Jan 2019

    Clinical features and long-term surgical outcomes of the patients with cervical spondylotic amyotrophy.

    • Tiefeng Li, Guodong Shi, Lei Shi, Jinhao Miao, Deyu Chen, and Yu Chen.
    • Spine Center, Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai, China.
    • World Neurosurg. 2019 Jan 1; 121: e172-e180.

    BackgroundCervical spondylotic amyotrophy (CSA) is not common. The clinical features and long-term surgical outcomes of patients with CSA are also unclear. We sought to summarize clinical features, assess long-term surgical outcomes, and determine the prognostic factors relevant for patients with CSA.MethodsA total of 136 patients with CSA who underwent anterior or posterior decompression during January 2001 to December 2012 were included. Their clinical and radiologic data were collected. The surgical outcome was evaluated using manual muscle test and improvements in the muscle strength. Correlations between the surgical outcome and various factors also were analyzed.ResultsIn total, 128 patients underwent anterior decompression and 8 patients underwent posterior decompression. At the final follow-up, the surgical outcome was significantly better after anterior decompression compared with that after posterior decompression. Statistical analyses showed the type of CSA, duration of symptoms, and association with ossification of the posterior longitudinal ligament were associated with a poor outcome after anterior surgery (P < 0.05).ConclusionsBesides significant muscular atrophy in one upper extremity, CSA also occasionally presents with mild atrophy in the other upper extremity, sensory disturbance in the upper extremities, or hyperflexia in the lower extremities. Anterior decompression is generally effective in the treatment of patients with CSA. Preoperative duration of symptoms, type of CSA, and ossification of the posterior longitudinal ligament are important predictors for the surgical outcome.Copyright © 2018 Elsevier Inc. All rights reserved.

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