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PubMed1979

Degeneration of the intervertebral disks and spondylosis in aging sand rats.

Aging sand rats (Psammomys obesus) kept on a standard laboratory diet supplemented by salt bush--their natural source of food--were examined for changes of the vertebral column. From about 6 months of age on, degeneration of the intervertebral disks was noted. The changes increased in severity with increasing age, and from 1 1/2 years of age on, massive multiple disk herniations were seen. Associated with these lesions were spondylosis of "intervertebral" as well as hyperostotic type, and osteoarthrosis of the apophyseal joint. The sand rat seems to be an excellent model for the study of the pathogenesis of spinal diseases associated with the aging process.

Aging↗
PubMed1983

Treatment of cervical spondylosis. Electroacupuncture versus physiotherapy.

A prospective, controlled clinical trial was undertaken to assess the relative efficacies of physiotherapy and electroacupuncture in the treatment of cervical spondylosis. The results suggested that, while both methods were effective, electroacupuncture produced an earlier symptomatic improvement with increased neck movement, especially in patients with mild degenerative changes of the cervical spine.

Acupuncture Therapy↗
PubMedDate not supplied

Myelopathy and radiculopathy due to cervical spondylosis: myelographic-CT correlations.

Forty patients with symptoms and signs of radicular disease or spinal cord involvement secondary to cervical spondylosis were studied with myelography (using nonionic water-soluble contrast medium) followed by computed tomographic (CT) myelography. In 17 patients CT was also performed before myelography. CT myelography adds useful information to the myelographic findings. Cord compression is better evaluated and osteophytes can be differentiated from disk herniation. Plain CT can demonstrate a herniated disk but with less accuracy than CT myelography. Cord and root compression are not seen directly on plain CT; for this reason myelography should be the first procedure in patients with myelopathy or myeloradiculopathy, which may be followed by CT myelography.

Adult↗
PubMed1984

"Open door" operation to raise the vertebral arch in myelopathy due to cervical spondylosis.

The authors discuss the various operations used in the treatment of myelopathy caused by cervical spondylosis. Recently they have used the so-called "open door" operation, which raises the posterior vertebral arch, in place of laminectomy, hemilaminectomy and anterior interbody fusion. The "open door" operation is less radical, less traumatizing and safer, and ensures considerable enlargement of the vertebral canal. This enlargement can be clearly demonstrated by tomography as well as by the traditional radiological methods.

Aged↗
PubMed1978

Oil myelography in cervical spondylosis.

Oil myelograms were performed on 62 patients with cervical spondylosis and signs of cervical root compression; 185 abnormal roots were seen. A filling defect of greater than or equal to 50% of the thickness of the lateral oil column usually coincided with clinical symptoms from the same root (42/52); 23 such patients were operated on, and 18 had their symptoms relieved. Of 133 roots with less severe abnormalities, only 53 were presumed to be the cause of the clinical symptoms or signs; 16 such patients were operated on, and 7 of them benefited from the operation.

Adult↗
PubMed1981

[Benoxaprofen in the treatment of spondylosis and spondylarthrosis (author's transl)].

An open clinical trial of 4 weeks included 32 patients with spondylosis and spondylarthrosis diagnosed on the average about 10 years previously. The non-steroid antirheumatic benoxaprofen was used alone in a dosage of a 1 x 600 mg tablet daily. The treatment had a marked influence on the clinical picture in the form of reduction of the pain at the beginning of movement, and of pains at night or on pressure. The extent of the night pains was already reduced to a statistically significant degree (alpha less than or equal to 0.05) after 1 week and remained so during the course of the treatment. Three patients had to discontinue the treatment prematurely because of side effects (photosensitivity in 2 and gastric intolerance in 1). No negative influence on clinical chemical or hematological parameters was seen in any of the patients.

Acetaminophen↗
PubMed1981

[Roentgenological measurement of the cervical vertebral bodies in ossification of the posterior longitudinal ligament (OPLL) and cervical spondylosis (CS) (author's transl)].

Many studies of the pathogenesis of ossification of posterior longitudinal ligaments (OPLL) have been reported, and both general and local factors have been pointed out. In case a longitudinal ligament is affected by both the general and local OPLL factors for many years, the shape and size of the cervical vertebral bodies and the arrangement of the cervical spinal column might be affected. The relation between OPLL and disc degeneration, the morphology of the facet joint and the change of longitudinal ligament tension has been reported by many authors. But the relation between OPLL and the shape, size and arrangement of cervical vertebral bodies has not been reported. We selected X-ray films of the lateral view of cervical spines which had been taken at our hospital since 1975. The subjects consisted of 190 cases in Group I and 189 cases in Group II. Half of Group I had OPLL, of which 71 were males and 24 females. The other half of Group I was composed of 95 cases (CS) of cervical spondylosis of the same sex and age distribution. Group II comprised 189 cases, all males aged 49 yrs. Of them, 41 were OPLL cases, 102 CS, and 46 normal subjects. The X-ray films of Group II were taken during medical examinations. The height, antero-posterior diameter of the cervical vertebral bodies and the antero-posterior diameter of the cervical spinal canals were measured and examined for kyphosis between the two neighbouring cervical vertebral bodies, disc space narrowing and Barsony ossification. The height and antero-posterior diameter of the cervical vertebral bodies were compared among the following groups. 1) the 3 groups divided according to age (-49,50-59,60-75 yrs.), 2) segmental type with non-segmental type, 3) OPLL only at C3 and C4 with OPLL only at C5, C6, and C7. The results were as follows: The cervical vertebral bodies of OPLL were taller and wider than those of CS. Cervical vertebral bodies of the older group were shorter and wider than those of the younger groups in both OPLL and CS. THe relative height (C3 = I) of OPLL group was very close to Normal group. The cervical vertebral bodies of non-segmental type were taller but not wider than those of segmental type of OPLL group. The C3 and C4 vertebral bodies with OPLL only at C3 and C4 were taller, but not wider than those with OPLL only at C5, C6 and C7. The antero-posterior diameter of cervical spinal canal of OPLL was narrower than CS group. The above data indicate the following: 1) With advance in age, cervical vertebral bodies become lower and wider. 2) The cervical vertebral body of OPLL is taller and wider than that of CS. 3) The level of OPLL and the type of OPLL have a relation to the height of cervical vertebral body. 4) The cervical vertebral bodies which have OPLL are wider than non-OPLL. But the level and the type of OPLL have no relation with the A-P diameter of the cervical vertebral body.

Adult↗
PubMed1994

[Double crush syndrome in patients with cervical spondylosis or ossification of posterior longitudinal ligament--a clinicophysiological study].

To clarify the clinical characteristics of double crush syndrome (DCS), we evaluated 207 patients with cervical spondylosis (CS) and 19 with ossification of posterior longitudinal ligament of the cervical spine (OPLL) clinicophysiologically. A diagnosis of DCS was based on the following criteria; 1) radiological evidence of CS or OPLL on X-ray films; 2) definite spinal cord compression on cervical magnetic resonance imaging (MRI); 3) neurological deficits in the upper extremities resulting from CS or OPLL; and 4) clinical and/or electrophysiological evidence of entrapment neuropathies in the upper extremities, namely carpal tunnel syndrome (CaTS), Guyon's tunnel syndrome (GTS), and/or cubital tunnel syndrome (CuTS). Pressure-provocative tests were used to confirm clinical entrapment neuropathies. Nerve conduction velocities were also examined. We found 28 patients with DCS (23 CS, 5 OPLL; 12.8% of all patients). There were 9 patients with clinical and electrophysiological DCS, 5 with clinical DCS, and 14 with electrophysiological DCS. Of the total number of patients with DCS, 21 proved to have CaTS, 4 had CuTS, 1 had GTS, 1 had both CaTS and CuTS, and 1 had both CaTS and GTS. Definite spinal cord compression was seen at C5/6 (23 patients), C4/5 (21), C3/4 (13) and C6/7 (10) on cervical MRI. In the majority of patients, neurological deficits of the upper extremities did not result from a single peripheral nerve lesion. It is well known that a discrepancy between neurological manifestation and neuro-imaging sometimes occurs in CS and OPLL, and circulatory disturbance in the spinal cord has been considered a possible pathogenetic mechanism of the disorder.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Cervical spondylosis: a review of 230 cases.

Between January 1981 and March 1991, 230 patients of cervical spondylosis were treated surgically. The choice of surgical approach was dependent on clinicoradiological presentation. Anterior discectomy was performed in 105 cases decompressive laminectomy in 119 cases and combined approach in 6 cases. In anterior discectomy group 89% showed improvement, 4% remained unchanged and 7% worsened. In decompressive laminectomy group 68% improved, 15% unchanged, 15% worsened and 1.6% died. In combined approach 66% showed improvement, 17% remained unchanged and 17% died. Anterior discectomy had less risk of overall complications than decompressive laminectomy.

Adult↗
PubMed1994

The biological factors in the etiopathogenesis and management of cervical spondylosis.

Two hundred cases of cervical spondylosis were studied for 1 to 4 average (2 1/2) years. No co-relation could be established between the clinical features and the radiological findings in these cases. It was found that parasites play an important role in the multifactorial etiology of this condition and their eradication by deworming drugs gives better results than the traditional therapies. Many new hypotheses are proposed to explain the same.

Adolescent↗
PubMedDate not supplied

Pathophysiology and rationale for treatment in lumbar spondylosis and instability.

The author discuss the pathophysiology and the rationale for treatment of low back pain in spondylosis and instability. The concept of the three phases of degeneration is useful in understanding [correction of the comprensione] the clinic-pathological correlations. Surgical indications for low back pain and sciatic are rare, because of the natural history of degenerative instability and spinal stenosis is usually benign. Surgical treatment, decompression and/or fusion, is indicated when conservative treatment fails. Decompression is indicated, in addition to disc herniation, for central and lateral stenosis. Fusion is indicated for lytic and degenerative spondylolisthesis, after facetectomy, in some cases of scoliosis. Simple degenerative disc disease, in the absence of herniation, nerve compression or instability, is not an indication for surgery. There is no proof yet that fusion for back pain alone, due to degenerative disc disease, is better than the natural history of the disease.

Biomechanical Phenomena↗
PubMed1993

[Involvement of the anterior longitudinal ligament of the spine in the morphogenesis of osteophytes in spondylosis deformans].

Morphology and relief of the mineralizing front of osteophytes associated with lumbar spondylosis have been studied by means of scanning electron microscopy. During osteophyte formation deep-laid fibers of anterior longitudinal ligament of the spine undergo mineralization followed by their resorption and subsequent replacement by bone structures. Osteophyte surface at its apex consists of mineralized fibers of longitudinal ligament of the spine, formed by mineralized cartilage structures in the area adjacent to the intervertebral disk and by resting bone surface with zone of bone formation and resorption in the area adjacent to longitudinal ligament of the spine.

Aged↗
PubMed1993

[Cervical spondylosis. Resection by oblique transcorporeal approach].

Spondylosis at the cervical level inducing anterior spinal cord compression is generally treated by anterior transcorporeal resection of the osteophytic spurs. We report on 12 cases over 2 years in which a new technique has been applied; it uses the lateral approach exposing and retracting laterally the vertebral artery; then, the vertebral bodies are drilled out obliquely from the anterolateral corner to the posterolateral one on the opposite side. The vertebral bodies were drilled using this technique on 1 level in 2 cases, on 2 levels in 4, on 3 levels in 5 and on 4 levels in 1; the C4-C5, C5-C6 and C6-C7 levels were the most frequent sites involved in 9, 8 and 6 cases respectively. No graft or arthrodesis was used since the stability of the spine was never compromised. Improvement of the neurological symptoms was observed in all the cases with the best results achieved on the motor deficit and sphincter disturbances. Every case was controlled by dynamic standard radiographies (flexion-extension), CT scan and MRI. The results were good in all cases in terms of osteophytes resection, spinal cord decompression and spinal stability. This technique of oblique resection of the cervical bodies seems quite efficient to alleviate spondylotic compression of the spinal cord; moreover, it appears simpler and safer than the anterior route since the operative field is much wider with all the vital structures protected and retracted medially and bone grafting is never necessary.

Adult↗
PubMedDate not supplied

Cervical spondylosis. An update.

Cervical spondylosis is caused by degenerative disc disease and usually produces intermittent neck pain in middle-aged and elderly patients. This pain usually responds to activity modification, neck immobilization, isometric exercises, and medication. Neurologic symptoms occur infrequently, usually in patients with congenital spinal stenosis. For these patients, magnetic resonance imaging is the preferred initial diagnostic study. Because involvement of neurologic structures on imaging studies may be asymptomatic, consultation with a neurologist is advised to rule out other neurologic diseases. In most cases of spondylotic radiculopathy, the results of conservative treatment are so favorable that surgical intervention is not considered unless pain persists or unless there is progressive neurologic deficit. If indicated, a surgical procedure may be done through the anterior or posterior cervical spine; results are gratifying, with long-term improvement in 70% to 80% of patients. Cervical spondylotic myelopathy is the most serious and disabling condition of this disease. Because many patients have nonprogressive minor impairment, neck immobilization is a reasonable treatment in patients presenting with minor neurologic findings or in whom an operation is contraindicated. This simple remedy will result in improvement in 30% to 50% of patients. Surgical intervention is indicated for patients presenting with severe or progressive neurologic deficits. Anterior cervical approaches are generally preferred, although there are still indications for laminectomy. Surgical results are modest, with good initial results expected in about 70% of patients. Functional outcome noticeably declines with long-term follow-up, which raises the question of whether, and how much, surgical treatment affects the natural course of the disease. Prospective randomized studies are needed to answer these questions.

Aged↗
PubMed1996

Advanced cervical spondylosis with ossification into the posterior longitudinal ligament and resultant neurologic sequelae.

Advanced cervical spondylosis (ACS) with ossification of the posterior longitudinal ligament (OPLL) may be distinguished from classical OPLL on magnetic resonance- and computed tomography-based studies by the presence within the hypertrophied posterior longitudinal ligament (PLL) of segments of punctate calcification-ossification. Between 1989 and 1993, 50 patients with an early form of classical OPLL, variably associated with ACS, had cervical surgery. Averaging in their mid-40s in age, and exhibiting signs of radiculopathy or myeloradiculopathy, patients were uniformly managed with anterior surgical decompression and fusion. The average follow-up interval was 38 months (range 18-66 months). In select patients, early OPLL coexisted with classic OPLL. ACS with OPLL may represent an early form of the generation of classic OPLL in younger symptomatic individuals, which may be successfully addressed with an anterior surgical approach.

Adult↗
PubMed1976

Cervical spondylosis: most common cause of position and vibratory sense loss.

At present, spondylosis of the cervical spine is the most common cause of loss of position and vibratory sense. The loss is asymmetric in regard to location and degree of involvement and results from intermittent contusion of the posterior columns against the lamina in persons having congenital narrow spinal canal. Subluxation of the vertebrae, reversal of cervical lordosis, and a hypertrophic ligamentum flavum further compromise the canal. Measurement of the anteroposterior diameter of the spinal canal is meaningful, as a narrow canal correlates best with the clinical symptoms. Not all patients with a narrow sagittai diameter have clinical signs, but all patients with clinical signs have a narrow sagittal diameter. Immobilization of the cervical spine in partial flexion with a light collar is the proper treatment in the absence of spinal fluid block.

Aged↗