| Degenerative spondylolisthesis of the cervical spine--symptoms and surgical strategies depending on disease progress. | |
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MedLine Citation:
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PMID: 15221569 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Degenerative spondylolisthesis of the cervical spine is rare. Patients show signs of progredient myelopathy, radiculopathy and pain. Treatment strategies include ventral, dorsal and combined fusion techniques with or without repositioning and decompression. METHODS: In this study, we present 16 patients with degenerative cervical spondylolisthesis. The leading symptom was severe myelopathy in 8 patients, radiculomyelopathy in 5 patients and neck pain in 3 patients. However, neck pain was the initial symptom in all the patients and decreased when neurological symptoms became more evident. Radiographic examinations included plain radiography, MRI, CT, myelography and lateral tomography. RESULTS: Spondylolisthesis was located five times at level C3/4, C4/5 and C5/6. In three cases spondylolisthesis was located at level C7/T1. There were two patients with spondylolisthesis on two levels. Instability could be demonstrated by flexion/extension radiography in five cases. Patients were divided into three groups according to a newly introduced classification system. The surgical approach corresponded to this classification. In ten patients the spondylolisthesis could be corrected by extension and positioning, so discectomy and fusion on one or two levels with cage, plate and screws was sufficient. In five cases a corpectomy was necessary due to severe spondylosis. In one case a combined approach with dorsal decompression and release followed by ventral fusion was applied due to additional dorsal spinal cord compression. The follow-up period was 6-52 months. After surgery, none of the patients showed any signs of neurological deterioration. In all cases, a stable fusion was achieved with no signs of instability on flexion/extension radiographs. Neurological improvement was seen in 6 of 8 patients with myelopathy and 4 of 5 patients with radiculomyelopathy. The others showed stable disease. Pain relief was seen in all patients who complained of pain preoperatively. CONCLUSION: The aims of treatment for cervical spondylolisthesis are spinal cord decompression (ventral, dorsal or both), correction and fusion. The used procedure should depend on the severity of the cervical deformity, degree and side of the spinal cord compression, and the possibility of correction by extension and positioning. |
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Authors:
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Christian Woiciechowsky; Ulrich-Wilhelm Thomale; Stefan-Nikolaus Kroppenstedt |
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Publication Detail:
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Type: Journal Article Date: 2004-06-22 |
Journal Detail:
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Title: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society Volume: 13 ISSN: 0940-6719 ISO Abbreviation: Eur Spine J Publication Date: 2004 Dec |
Date Detail:
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Created Date: 2005-01-21 Completed Date: 2005-06-30 Revised Date: 2013-03-14 |
Medline Journal Info:
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Nlm Unique ID: 9301980 Medline TA: Eur Spine J Country: Germany |
Other Details:
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Languages: eng Pagination: 680-4 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Charité-Campus Virchow-Klinikum, University Medicine of Berlin, 13444, Berlin, Germany. christian.woiciechowsky@charite.de |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cervical Vertebrae / pathology, radiography, surgery* Decompression, Surgical / methods*, standards, statistics & numerical data Disease Progression Female Humans Internal Fixators / standards, statistics & numerical data, trends Magnetic Resonance Imaging Male Middle Aged Neck Pain / etiology, physiopathology, surgery Postoperative Complications Radiculopathy / etiology, physiopathology, surgery Retrospective Studies Spinal Cord Compression / etiology, physiopathology, surgery* Spinal Fusion / methods*, standards, statistics & numerical data Spondylolisthesis / pathology, physiopathology, surgery* Tomography, X-Ray Computed Treatment Outcome |
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