Stop Movement in Cervical Spine to Prevent Further Neurologic Symptoms
Disc herniation in the neck can cause pressure on the spinal cord. The result is a problem called cervical compression myelopathy (CCM). Patients with this condition can have neck and arm pain. As CCM gets worse, numbness and tingling down the arm with weakness and muscle atrophy (wasting) can occur.
The treatment for CCM remains under question. Removing the disc and fusing the spine is often done. It would be helpful if doctors could tell which patients need this kind of treatment. Some studies show that younger patients get better faster than older adults with this type of operation. But other studies don't show age as a predictive factor of success at all.
There is some thought that symptom duration makes a difference. It may be that the longer the patient has symptoms before the surgery, the worse the results will be after surgery. And it's been suggested that patients with worse symptoms before surgery tend to have less pain relief and less improvement in function when compared to patients who had milder symptoms before the operation.
In this study, 20 patients with CCM were tested before and after surgery. Surgery included disc removal and anterior fusion of the spine. Preoperative age, duration of symptoms, and severity of symptoms were compared to postoperative results. Curvature of the spine and MRI findings were also compared.
The authors found that it was really the fusion itself that made the difference. Everyone got better, even those patients whose MRIs still showed signs of significant compression. The fact that they couldn't move their spine at the affected level (due to the fusion) seemed to make the most difference. Age and symptom duration didn't seem to make any difference for this group.
Mehmet Sorar, MD, et al. Cervical Compression Myelopathy: Is Fusion the Main Prognostic Indicator? In Journal of Neurosurgery: Spine. Vol. 6. No. 6. Pp. 531-539.
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