Advertisement

Degenerative Cervical Spine Disease

  • Andrei Fernandes Joaquim
  • Otávio Turolo da Silva
  • John Rhee
  • K. Daniel Riew
Chapter

Abstract

Although cervical spondylosis is ubiquitous with aging, symptomatic cervical radiculopathy or myelopathy is much less common and is better named as cervical degenerative disease. Many people have degenerative radiographic changes without significant clinical symptoms. When symptomatic, cervical axial pain is generally managed nonsurgically. Cervical radiculopathy generally has a benign course, with improvement in days to weeks in the majority of patients. Surgery is reserved for those patients with severe pain refractory to medication and nonsurgical measures or those with progressive, significant neurological deficits. Cervical myelopathy due to spondylotic changes is the most common cause of spinal cord dysfunction in older adults. It is generally treated surgically, especially in those with progressive worsening. Recognizing signs and symptoms of severity are important for early referral of these patients for specific care, since surgical treatment may be necessary in some patients to improve or at least maintain neurological function.

Keywords

Cervical degenerative disease Radiculopathy Myelopathy 

Suggested Readings and References

  1. 1.
    Alafifi T, Kern R, Fehlings M. Clinical and MRI predictors of outcome after surgical intervention for cervical spondylotic myelopathy. J Neuroimaging. 2007;17(4):315–22.  https://doi.org/10.1111/j.1552-6569.2007.00119.x.CrossRefPubMedGoogle Scholar
  2. 2.
    Benzel EC, Lancon J, Kesterson L, Hadden T. Cervical laminectomy and dentate ligament section for cervical spondylotic myelopathy. J Spinal Disord. 1991;4(3):286–95.CrossRefGoogle Scholar
  3. 3.
    Fehlings MG, Barry S, Kopjar B, Yoon ST, Arnold P, Massicotte EM, Vaccaro A, Brodke DS, Shaffrey C, Smith JS, Woodard E, Banco RJ, Chapman J, Janssen M, Bono C, Sasso R, Dekutoski M, Gokaslan ZL. Anterior versus posterior surgical approaches to treat cervical spondylotic myelopathy: outcomes of the prospective multicenter AOSpine North America CSM study in 264 patients. Spine. 2013;38(26):2247–52.  https://doi.org/10.1097/BRS.0000000000000047.CrossRefPubMedGoogle Scholar
  4. 4.
    Fehlings MG, Wilson JR, Kopjar B, Yoon ST, Arnold PM, Massicotte EM, Vaccaro AR, Brodke DS, Shaffrey CI, Smith JS, Woodard EJ, Banco RJ, Chapman JR, Janssen ME, Bono CM, Sasso RC, Dekutoski MB, Gokaslan ZL. Efficacy and safety of surgical decompression in patients with cervical spondylotic myelopathy: results of the AOSpine North America prospective multi-center study. J Bone Joint Surg Am. 2013;95(18):1651–8.  https://doi.org/10.2106/JBJS.L.00589.CrossRefPubMedGoogle Scholar
  5. 5.
    Fouyas IP, Statham PF, Sandercock PA. Cochrane review on the role of surgery in cervical spondylotic radiculomyelopathy. Spine. 2002;27(7):736–47.CrossRefGoogle Scholar
  6. 6.
    Gandhoke G, Wu JC, Rowland NC, Meyer SA, Gupta C, Mummaneni PV. Anterior corpectomy versus posterior laminoplasty: is the risk of postoperative C-5 palsy different? Neurosurg Focus. 2011;31(4):E12.  https://doi.org/10.3171/2011.8.FOCUS11156.CrossRefPubMedGoogle Scholar
  7. 7.
    Grob D. Surgery in the degenerative cervical spine. Spine. 1998;23(24):2674–83.CrossRefGoogle Scholar
  8. 8.
    Harrop JS, Naroji S, Maltenfort M, Anderson DG, Albert T, Ratliff JK, Ponnappan RK, Rihn JA, Smith HE, Hilibrand A, Sharan AD, Vaccaro A. Cervical myelopathy: a clinical and radiographic evaluation and correlation to cervical spondylotic myelopathy. Spine. 2010;35(6):620–4.  https://doi.org/10.1097/BRS.0b013e3181b723af.CrossRefPubMedGoogle Scholar
  9. 9.
    Joaquim AF, Appenzeller S. Cervical spine involvement in rheumatoid arthritis--a systematic review. Autoimmun Rev. 2014;13(12):1195–202.  https://doi.org/10.1016/j.autrev.2014.08.014.CrossRefPubMedGoogle Scholar
  10. 10.
    Joaquim AF, Cheng I, Patel AA. Postoperative spinal deformity after treatment of intracanal spine lesions. Spine J. 2012;12(11):1067–74.  https://doi.org/10.1016/j.spinee.2012.09.054.CrossRefPubMedGoogle Scholar
  11. 11.
    Joaquim AF, Ghizoni E, Anderle DV, Oliveira E, Tedeschi H. Axis instrumentation: surgical results. Arq Neuropsiquiatr. 2012;70(11):857–63.CrossRefGoogle Scholar
  12. 12.
    Kadanka Z, Bednarik J, Novotny O, Urbanek I, Dusek L. Cervical spondylotic myelopathy: conservative versus surgical treatment after 10 years. Eur Spine J. 2011;20(9):1533–8.  https://doi.org/10.1007/s00586-011-1811-9.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Kaminsky SB, Clark CR, Traynelis VC. Operative treatment of cervical spondylotic myelopathy and radiculopathy. A comparison of laminectomy and laminoplasty at five year average follow-up. Iowa Orthop J. 2004;24:95–105.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Kato S, Oshima Y, Oka H, Chikuda H, Takeshita Y, Miyoshi K, Kawamura N, Masuda K, Kunogi J, Okazaki R, Azuma S, Hara N, Tanaka S, Takeshita K. Comparison of the Japanese Orthopaedic Association (JOA) score and modified JOA (mJOA) score for the assessment of cervical myelopathy: a multicenter observational study. PLoS One. 2015;10(4):e0123022.  https://doi.org/10.1371/journal.pone.0123022.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    LaRocca H. Cervical spondylotic myelopathy: natural history. Spine. 1988;13(7):854–5.CrossRefGoogle Scholar
  16. 16.
    Law MD Jr, Bernhardt M, White AA 3rd. Cervical spondylotic myelopathy: a review of surgical indications and decision making. Yale J Biol Med. 1993;66(3):165–77.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Macdonald RL, Fehlings MG, Tator CH, Lozano A, Fleming JR, Gentili F, Bernstein M, Wallace MC, Tasker RR. Multilevel anterior cervical corpectomy and fibular allograft fusion for cervical myelopathy. J Neurosurg. 1997;86(6):990–7.  https://doi.org/10.3171/jns.1997.86.6.0990.CrossRefPubMedGoogle Scholar
  18. 18.
    Matz PG, Anderson PA, Holly LT, Groff MW, Heary RF, Kaiser MG, Mummaneni PV, Ryken TC, Choudhri TF, Vresilovic EJ, Resnick DK, Joint Section on Disorders of the S, Peripheral Nerves of the American Association of Neurological S, Congress of Neurological S. The natural history of cervical spondylotic myelopathy. J Neurosurg Spine. 2009;11(2):104–11.  https://doi.org/10.3171/2009.1.SPINE08716.CrossRefPubMedGoogle Scholar
  19. 19.
    Nouri A, Martin AR, Mikulis D, Fehlings MG. Magnetic resonance imaging assessment of degenerative cervical myelopathy: a review of structural changes and measurement techniques. Neurosurg Focus. 2016;40(6):E5.  https://doi.org/10.3171/2016.3.FOCUS1667.CrossRefPubMedGoogle Scholar
  20. 20.
    Nurick S. The natural history and the results of surgical treatment of the spinal cord disorder associated with cervical spondylosis. Brain. 1972;95(1):101–8.CrossRefGoogle Scholar
  21. 21.
    Nurick S. The pathogenesis of the spinal cord disorder associated with cervical spondylosis. Brain. 1972;95(1):87–100.CrossRefGoogle Scholar
  22. 22.
    Patel AA, Spiker WR, Daubs M, Brodke DS, Cannon-Albright LA. Evidence of an inherited predisposition for cervical spondylotic myelopathy. Spine. 2012;37(1):26–9.  https://doi.org/10.1097/BRS.0b013e3182102ede.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Satomi K, Nishu Y, Kohno T, Hirabayashi K. Long-term follow-up studies of open-door expansive laminoplasty for cervical stenotic myelopathy. Spine. 1994;19(5):507–10.CrossRefGoogle Scholar
  24. 24.
    Tetreault LA, Kopjar B, Vaccaro A, Yoon ST, Arnold PM, Massicotte EM, Fehlings MG. A clinical prediction model to determine outcomes in patients with cervical spondylotic myelopathy undergoing surgical treatment: data from the prospective, multi-center AOSpine North America study. J Bone Joint Surg Am. 2013;95(18):1659–66.  https://doi.org/10.2106/JBJS.L.01323.CrossRefPubMedGoogle Scholar
  25. 25.
    Wilson JR, Fehlings MG, Kalsi-Ryan S, Shamji MF, Tetreault LA, Rhee JM, Chapman JR. Diagnosis, heritability, and outcome assessment in cervical myelopathy: a consensus statement. Spine. 2013;38(22 Suppl 1):S76–7.  https://doi.org/10.1097/BRS.0b013e3182a7f4bf.CrossRefPubMedGoogle Scholar
  26. 26.
    Wilson JR, Patel AA, Brodt ED, Dettori JR, Brodke DS, Fehlings MG. Genetics and heritability of cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament: results of a systematic review. Spine. 2013;38(22 Suppl 1):S123–46.  https://doi.org/10.1097/BRS.0b013e3182a7f478.CrossRefPubMedGoogle Scholar
  27. 27.
    Wilson JR, Tetreault LA, Kim J, Shamji MF, Harrop JS, Mroz T, Cho S, Fehlings MG. State of the art in degenerative cervical myelopathy: an update on current clinical evidence. Neurosurgery. 2017;80(3S):S33–45.  https://doi.org/10.1093/neuros/nyw083.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Andrei Fernandes Joaquim
    • 1
  • Otávio Turolo da Silva
    • 1
  • John Rhee
    • 2
  • K. Daniel Riew
    • 3
  1. 1.Department of Neurology, Neurosurgery DivisionUniversity of Campinas (UNICAMP)CampinasBrazil
  2. 2.Department of Orthopaedic Surgery and NeurosurgeryEmory UniversityAtlantaUSA
  3. 3.Department of Orthopedic SurgeryDaniel and Jane Och Spine Hospital – New York Presbyterian HospitalNew YorkUSA

Personalised recommendations