Önemli bir tetraparezi nedeni: Servikal spondilotik miyelopati

Servikal spondilotik miyelopati (SSM) servikal omurlarda dejeneratif değişiklikler sonucunda gelişen spinal kanalda daralmaya bağlı nörolojik bir bozukluktur. Spondiloz, omurilik ve sinir köklerini, bir veya birden fazla segmentte etkileyerek miyelopati oluşturabilmektedir. Gelişmiş ülkelerde 55 yaş üzerindeki olgularda en sık rastlanan miyelopati nedenidir. Ayrıca hayatın orta ve ileri dönemlerinde en sık karşılaşılan kazanılmış spastik paraparezi nedenidir. Bu yazıda SSMnin tanı ve alternatif tedavi yöntemleri tartışıldı.

An important cause of tetraparesis: Cervical spondylotic myelopathy

Cervical spondylotic myelopathy which is a neurologic disorder caused by degenerative changes in the cervical spines related to narrowing in the spinal channel. Spondylosis may cause myelopathy effecting spinal cord or nerve roots in one or more segments. It is most common cause of myelopathy over the 55 years of age in developed countries. As well as it is most commonly seen acquired spastic paraparesis in medium and late times of life. We discuss diagnosis and alternative treatment options in cervical spondylotic myelopathy in the current study

___

  • 1. Kojima T, Waga T. Anterior cervical vertebrectomy and interbody fusion for multilevel spondylosis and ossification of the posterior longitudinal ligament. Neurosurgery 1989;24:864-871.
  • 2. Braakman R. Management of cervical spondylotic myelopathy and radiculopathy. J Neurol Neurosurg Psychiatry 1994;57:257-263.
  • 3. Nagashima H, Dokai T, Hashiguchi H, et al. Clinical features and surgical outcomes of cervical spondylotic myelopathy in patients aged 80 years or older: a multi-center retrospective study. Eur Spine J 2011;20:240-246.
  • 4. Ranawat CS, O Leary P, Pellia P. Cervical spine fusion in rheumatoid arthritis. J Bone Joint Surg 1979;61:1003-1010.
  • 5. Cooper PR: Cervical spondylotic myelopathy. Contemporary Neurosurgery 1997;19:1-7
  • 6. Wilkinson M. Cervical spondylosis: Its early diagnosis and treatment ed. 2. Philadelphia WB Saunders, 1971.
  • 7. Ogina H, Tada K. Canal diameter, anteroposterior compression ratio and spondylotic myelopathy of cervical spine. Spine 1983;8:1-15.
  • 8. Montogomery DM, Bower RS. Cervical spondylotic myelopathy. In: Garfin SR (ed), The Orthopedic Clinics of North America; The degenerative Neck, 1992:487-493.
  • 9. Clarke E, Robinson P: Cervical myelopathy, a complications of cervical spondlosis. Brain 1956;79:483-510.
  • 10. Rahim KA, Stambough JL. Radiographic evaluation of the degenerative cervical spine. In: Garfin SR (ed). The Orthopedic Clinics Of North America; The degenerative Neck, 1992:295-403.
  • 11. Clark CR: Differential diagnosis and nonoperative management, In The Adult Spine 2nd ed. Frymoyer JW (ed) 1997.
  • 12. Wang PY, Shen WC, Jan SR. Serial MRI changes in radiation myelopathy. Neuroradiol 1995;37;374-377.
  • 13. Avadhani A, Rajasekaran S, Shetty AP. Comparison of prognostic value of different MRI classifications of signal intensity change in cervical spondylotic myelopathy. Spine J 2010;10:475-485.
  • 14. Mehalic TF, Pezzuti RT, Applebaum BI. Magnetic resonance imaging and cervical spondylotic myelopathy. Neurosurgery 1990;26:217-227.
  • 15. Maıman D, Hoffman M. Electrodiagnostic studies in cervical spine disorders. In: Sherk HH (ed), The cervical spine (2nd ed). J. B: Lippincott, Philadelphia 1989; pp: 212-225
  • 16. Adams RD, Victor M, Ropper AH. Disease of the spinal cord. Principles of Neurology 6th ed 1997;1227-1277.
  • 17. Braverman DL, Lachmann EA, Tunkel R, Nagler W. Multiple sclerosis. Presenting as a spinal cord tumor. Arch Phys Med Rehabil 1997;78:1274-1276.
  • 18. Epstein NE. The surgical management of ossification of the posterior longitudinal ligament in 43 North Americans. Spine 1994;19:664-672.
  • 19. Ebersold MJ, Pare MC, Quest LM. Surgical treatment for cervical spondylotic myelopathy. J Neursurg 1995;82:745- 751.
  • 20. Epstein JA. The surgical management of cervical spinal stenosis, spondylosis and myeloradiculopathy by means of the posterior approach. Spine 1988;13:864-869.
  • 21. Cloward RB. The anterior approach for removal of ruptured cervikal disc. J Neurosurg 1958;15:602-617.
  • 22. Smith GW, Robinson RA. The treatment of certain cervical spine disorders by the anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg 1958;40: 607.
  • 23. Cabraja M, Abbushi A, Koeppen D, et al. Comparison between anterior and posterior decompression with instrumentation for cervical spondylotic myelopathy: sagittal alignment and clinical outcome. Neurosurg Focus 2010;28:15.
  • 24. Highsmith JM, Dhall SS, Haid RW, et al. Treatment of cervical stenotic myelopathy: a cost and outcome comparison of laminoplasty versus laminectomy and lateral mass fusion. J Neurosurg Spine 2011;14:619-625.
  • 25. Saunders RL, Bernin PM, Schiretts TG, et al. Central corpectomy for cervical spondylotic myelopathy: A consecutive series with long term follow-up evaluation. J Neurosurgery 1991;74:163-170.
  • 26. George B, Lot G, Mourrier KL, et al. Cervical spondylosis. Resection by oblique transcorporeal approach. Neurochirurgie 1993;39:171-177.
  • 27. Sakura H, Hosono N, Mukai Y, et al. Long-term outcome of laminoplasty for cervical myelopathy due to disc herniation. A comparative study of laminoplasty and anterior spinal fusion. Spine 2005;30:756-759.
  • 28. Satomi K, Nishu Y, Kohno T, et al. Long-term follow up study open-door expansive laminoplasty for cervical stenotic myelopathy. Spine 1994;19:507-510.
  • 29. Hirabayashi K, Satomi K. Operative procedure and results of expansive open-door laminoplasty. Spine 1988;13:870- 876.
  • 30. Flynn TB. Neurological complications of anterior interbody fusion. Spine 1982;7:536-539.
  • 31. Bilbao G, Duart M, Aurrecoechea JJ, et al. Surgical results and complications in a series of 71 consecutive cervical spondylotic corpectomies. Acta Neurochir 2010;152:1155- 1163.
  • 32. Kumar V, Rea GL, Mervis LJ, et al. Cervical spondylotic myelopathy: Functional and radiographic long term outcome after laminectomy and posterior fusion. Neurosurgery 1999;44:771-778.
  • 33. Bulger RF, Rejowski JE, Beatty RA. Vocal cord paralysis associated with anterior cervical fusıon. Consideration for prevention and treatment. J Neurosurg 1985;62:557-661.
  • 34. Koç RK, Menkü A, Akdemir H, et al. Cervical spondylotic myelopathy and radiculopathy treated by oblique corpectomies without fusion. Neurosurg Rev 2004;27:252-258.
  • 35. Wiberg J. Effect of surgery on cervical spondylotic myelopathy. Acta Neurochir 1986; 81:113-117.
Dicle Tıp Dergisi-Cover
  • ISSN: 1300-2945
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1963
  • Yayıncı: Cahfer GÜLOĞLU
Sayıdaki Diğer Makaleler

Maksillofasiyal ateşli silah yaralanmalarında atış yönünün belirlenmesinde radyografik görüntülemenin önemi

ADNAN ÇELİKEL, Cengiz ARLI, Cem ZEREN, Dua Sümeyra DEMİRKIRAN

Yanık yaralarından izole edilen patojenler ve antibiyotik direnç durumları

İlyas YOLBAŞ, Recep TEKİN, Selvi KELEKÇİ, C.selçuk TAYYAR, M.hanifi OKUR, İlhan TAN, Ünal ULUCA

Contribution of spiral artery blood flow changes assessed by transvaginal color Doppler sonography for predicting endometrial pathologies

Suna KUCUR KABİL, Alev AYDIN ATIŞ, Osman TEMİZKAN, İlay GÖZÜKARA, Eda Ülkü ULUDAĞ, Canan ACAR, İnci DAVAS

Adölesan dönemi ve öncesinde yapılan sünnetlerin karşılaştırılması

Mehmet Mazhar UTANĞAÇ, Mansur DAĞGÜLÜ, İsmail YAĞMUR

Comparison of the depth of anesthesia in sevoflurane and halothane anesthesia with bispectral index and 95% spectral edge frequency

Günhan GÖKAHMETOĞLU, Elvan TERCAN, Cihangir BİÇER, RECEP AKSU, Adem BOYACI

Single-port laparoscopic left colectomy for colo-colonic intussusception caused by giant lipoma

FAHRETTİN ACAR, Mustafa ŞAHİN, HÜSNÜ ALPTEKİN, Hüseyin YILMAZ, M. Ertuğrul KAFALI

Dev spermatosel: Olgu sunumu

HASAN RIZA AYDIN, HASAN TURĞUT, Yılmaz OFLUOĞLU, ŞENOL ADANUR, Tevfik ZİYPAK

Polikistik over sendromunda kardiyovasküler hastalık risk faktörü olarak C-reaktif protein düzeyi ve obezite

Eda Ülkü ULUDAĞ, İlay GÖZÜKARA, Suna KUCUR KABİL, Havva KESKİN, Halime KILIÇ, Zeynep KAMALAK, Ayşe KARGILI, Şenay DURMAZ ARIKAN

Postmenopozal kadınlarda serum vitamin D düzeyi ve kemik mineral yoğunluğunun denge ve düşme riski üzerine etkisi

Ayşegül TÜRKYILMAZ KÜÇÜKALİ, EMİNE EDA KURT, Gül DEVRİMSEL

The factors affecting morbidity and mortality in low birth-weight infants

Mervan BEKDAŞ, Sevil Bilir GÖKSUGÜR, Beyhan KÜÇÜKBAYRAK, Ayhan EKİCİ