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PubMed2006

[Effect of acupuncture and massage at tendon on F-wave of electromyogram in the patient of flexor spasm of the upper limb after operation of cervical spondylosis].

OBJECTIVE: To explore the mechanism of acupuncture and massage at the tendon in treatment of the upper limb flexor spasm after cervical operation. METHODS: Fifty-six cases were randomly divided into a treatment group (n = 30) treated with acupuncture and massage at the tendons, and a control group treated with traditional acupuncture and medication. Changes of F-wave, time limit and threshold value in electromyogram before and after treatment were investigated in the both groups. RESULTS: Before treatment, the F-wave in the patient of the upper limb spasm post-cervical operation was characterized by high amplitude, long time limit and low threshold value, with no significant difference between the two groups (P > 0.05); after treatment, the amplitude lowered (P < 0.01), the time limit shortened (P < 0.001) in the treatment group and no significant changes were found in the control group (P > 0.05), but the amplitude of F-wave in the treatment group was significantly lower than that in the control group (P < 0.05). The threshold value significantly increased in the two groups, with the treatment group more significantly increased than the control group (P < 0.05). CONCLUSION: Acupuncture and massage at tendons can relieve the spasm through lowing the excitement in the cells of the anterior horn of the spinal cord, decreasing the amplitude and time limit of the F-wave, increasing the threshold value and reducing traction reflection.

Acupuncture Therapy↗
PubMed1990

Spondylosis in sand rats: a model of intervertebral disc degeneration and hyperostosis.

This study defines gross, histopathologic, and radiologic changes associated with intervertebral disc degeneration in a spontaneously occurring form of the disease in aging sand rats (Psammomys obesus). Sand rats (male/female) fed lab chow supplemented with desert salt bush were sacrificed at periods of 3-30 months. Lateral thoracolumbar spine films were obtained. At sacrifice, spines were surgically exposed and gross findings were recorded; after fixation/decalcification, histopathologic studies were carried out using hematoxylin and eosin, and Safranin-O with fast green counterstain. Metabolic studies included correlations of pathologic and radiologic findings with blood glucose and insulin levels. Disc-space narrowing and subchondral endplate sclerosis increased radiologically with age, with more severe lower lumbar disc lesions. Ligamentous calcifications ventral to involved discs and caudal vertebrae were common. Disc thinning and anterior vertebral bony/cartilaginous spurs were more marked with age. Microscopy revealed loss of nucleus pulposus physaliform cells, chondrocyte replication, disc necrosis, and ossification. Hyperglycemia with and without hyperinsulinemia was common. No statistically significant differences in pathologic findings were noted, neither in diabetic versus nondiabetic nor in hyperinsulinemic animals. The sand rat is a model of disc degeneration; similarities with possible overlap with diffuse idiopathic skeletal hyperostosis syndrome were noted.

Aging↗
PubMed1978

Anterior fusion for cervical spondylosis.

Anterior fusion was performed on 138 patients as treatment for degenerative changes of the cervical vertebral column. The results were checked after up to 11 years in 122 patients and were found to be good in 55%, fair in 3895% and poor in 6.5%. There were complications of phonetic paralysis in one case, Horner syndrome in two cases, 2 wound infections, and complaints about the iliac crest in 3 patients. Kyphosis at the fused segment occurred 26.1% of cases, the average angle being 15.3 degrees, but it did not influence the clinical results. Mortality was 2%. Inadequate visualization of the nerve roots at operation was probably the reason for the segmental deficits and suggestions were made to avoid this by EMG, microsurgical technic, uncusectomy and hemifacetectomy. The results in the presence of myelopathy were much poorer, presumably because of associated degenerative changes in the older patients.

Adult↗
PubMed1984

On the pathogenesis of spondylosis deformans and arthrosis uncovertebralis: comparative form-analytical radiological and statistical studies on lumbar and cervical vertebral bodies.

To investigate the etiopathogenesis of the common clinical symptoms of the lower lumbar spine (LS) and cervical spine (CS) (lower back pain and local cervical spine syndrome), the dimensions of the third to fifth lumbar vertebral bodies (LVB) and the fifth to seventh cervical vertebral bodies (CVB) were studied quantitatively and morphometrically in frontal and sagittal planes, as a function of sex and age, in 105 human cadavers of both sexes aged between 16 and 91 years. The evaluation was done in X-ray pictures of 100-micron-thick polished bone sections with the aid of the Macro Facility of the Leitz Texture Analysis System. In each case, the maximum and minimum heights and widths and depths and the computed differences in heights, widths, and depths were determined. The results were evaluated statistically and compared within and between the two regions of the spine, using regression-correlation analyses. The heights, widths, and depths of the VB are all greater in men than in women; their behavior during ageing is, however, identical for both sexes. The heights of all the VB examined remain constant throughout life after termination of growth. The maximum widths and the width differences reveal an increase in both LVB and CVB in old age. All depth parameters reveal constancy in the case of the LVB but an increase in the case of the CVB in old age. The correlation coefficients of the maximum width of the VB within the spinal regions are very high in the LVB, but lower in the CVB. Between the two regions, in contrast, they are very low. This behavior suggests a superordinate action principle within each of the spinal regions which is based on characteristic anatomical construction and functional stressing. The static stressing of the LVB leads, laterally to disc protrusions. As a result of this, traction forces acting on the weak lateral elements of the anterior longitudinal ligament, stimulate the accretion of spondylotic osteophytes at the point of insertion of the ligament on the vertebral body. Anteriorly, in contrast, the particular strong anterior longitudinal ligament prevents such a remodelling process. Posteriorly, the longitudinal ligament is attached to the intervertebral discs, and can thus not stimulate the vertebral body to produce osteophytes. The dynamic stressing of the CVB leads laterally to friction between the VB in the region of the uncovertebral joints and to the formation of arthrotic osteophytes. Anteriorly, owing to the weak configuration of the anterior longitudinal ligament in this aspect, disc protrusion occur and, subsequently, spondylotic osteophytes accrete.

Adolescent↗
PubMed1997

Corpectomy for multi-level cervical spondylosis and ossification of the posterior longitudinal ligament.

The choice of a surgical approach for multi-level cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) is still a controversial issue. While most of the surgeons are still performing decompression by laminectomy, some are doing multi-level anterior decompression. Few neurosurgeons are performing decompression by corpectomy. We have treated 26 patients by median cervical corpectomy during the last 4 years. These patients were followed up for a mean period of 25 months. Twenty one (80%) patients had a good outcome, 2 patients remained unchanged and 3 expired. Review of the literature and our experience indicates that patients with CSM and OPLL should be operated by median cervical corpectomy (anterior approach).

Adult↗
PubMed1989

Surgical treatment of myeloradiculopathy in cervical spondylosis. A report on 438 operations.

In the past eleven years we have performed 438 microsurgical ventral discectomies with bilateral foraminotomy followed by fusion with palacos in the cervical spine in our clinic. An analysis of the preoperative symptoms shows a great variability and overlapping of the various segments. To determine the right level for the operation it is crucial that the results of the clinical and the radiological examinations be evaluated. The results of ascending myelography and CT scans are of great value. In cases of cervical myelopathy a multisegmental operation is often necessary to obtain good results. The complication rate was small in our patients and a second operation was only necessary in a few cases. We had very good postoperative results in radicular pain and muscle weakness. In patients with symptoms of cervical myelopathy we achieved considerable improvement.

Cervical Vertebrae↗
PubMed2006

[Spondylosis hyperostotica--a rare cause of dysphagia, dyspnea, and neck-shoulder pain].

Anterior or seldom posterior hyperostosis of the spine (Forestier disease, "diffuse idiopathic skeletal hyperostosis") is a common finding in elderly patients but is rarely associated with clinical symptoms. In some cases there is a wide range of symptoms which may not lead primarily to the correct diagnosis. We report a case in which the diagnosis was first made based on an unusual combination of symptoms after ENT and neurological examinations revealed no evidence for the underlying cause.

Aged↗
PubMed1998

Anterior interbody fusion with the BAK-cage in cervical spondylosis.

BAK-C is a new autostabilizing interbody cage which is implanted during an anterior cervical procedure to provide stability to the motion segment and allow fusion to occur. Special instrumentation is provided with a bone collecting reamer. The system utilizes surgical site bone graft as the osteo-inductive material within the implant. Biomechanical testing indicates improved stability and animal studies show good fusion. The basic principle is distraction-compression using the tension forces of the annulus fibrosus. Operative material concerns a two years experience with 80 patients (101 levels), 72 with cervical radiculopathy, 8 with myelopathy. Clinical evaluation is assessed on a ten point analogue pain scale for neck and arm/shoulder pain, with neurological examination. Radiological evaluation includes dynamic X-rays, myelo-CT and MRI. Patients are re-evaluated at 1, 6, 12 months postoperatively. Results for neck and radicular pain is excellent, but neurological recovery for radiculopathy and myelopathy is quite different. Radiological results are also good with (except one case) no instability, no cage migration, no kyphosis, no pseudarthrosis. Bone fusion is assessed at 6 and 12 months. Complications are few with proper technique, mainly correct distraction, symmetrical endplate drilling and lateral X-ray control. Only one patient needed an early re-operation with additional miniplate fixation. Immediate stability with good clinical response and no graft morbidity are the advantages of this implant compared to conventional cervical interbody grafting techniques.

Adult↗
PubMed1998

Anterior cervical decompression and fusion for cervical spondylosis using vertebral grafts obtained from the fusion site. Technical advantages and follow-up results.

A retrospective analysis was done in 60 consecutive patients who underwent anterior cervical fusion using vertebral grafts obtained from the fusion site at the Nagoya University and its affiliated hospitals by a single surgeon (MT). Follow-up results and technical advantages are reported. The average follow-up period was 33 months (range 6 to 55 months). Sufficient decompression of the anterior cervical pathology was performed successfully via a wider operative field. The symptoms and neurological score improved significantly without any new deficits in all patients except in one with a three-level fusion who needed re-operation for further decompression. No major graft complications such as graft extrusion or pseudoarthrosis occurred. Graft fracture was noted in five cases. However, good bony fusion was observed in all these cases without any further treatment. Normal cervical lordosis was preserved in most cases except in four, who lost lordotic alignment but did not show kyphosis. Major advantages of this method are a wider operative field, excellent graft fusion rate, and no need for an additional incision to obtain autogenous bone graft. These benefits seem have to contributed to satisfactory surgical results in this series.

Adult↗
PubMed1987

Syringomyelia after decompressive laminectomy for cervical spondylosis.

We describe a case of cervical spondylotic myelopathy in which deterioration occurred a month after decompressive laminectomy. Syringomyelia was then in evidence as seen by myelography and delayed metrizamide computed tomography scanning. The etiology of this finding and its possible relation to the course and treatment of cervical spondylotic myelopathy are discussed.

Adult↗