Year-end Sale % OFF 
Abstract
BackgroundIt has been stated that individuals who have spondylotic encroachment on the cervical spinal cord without myelopathy are at increased risk of spinal cord injury if they experience minor trauma. Preventive decompression surgery has been recommended for these individuals. The purpose of this paper is to provide the non-surgical spine specialist with information upon which to base advice to patients. The evidence behind claims of increased risk is investigated as well as the evidence regarding the risk of decompression surgery.MethodsA literature search was conducted on the risk of spinal cord injury in individuals with asymptomatic cord encroachment and the risk and benefit of preventive decompression surgery.ResultsThree studies on the risk of spinal cord injury in this population met the inclusion criteria. All reported increased risk. However, none were prospective cohort studies or case-control studies, so the designs did not allow firm conclusions to be drawn. A number of studies and reviews of the risks and benefits of decompression surgery in patients with cervical myelopathy were found, but no studies were found that addressed surgery in asymptomatic individuals thought to be at risk. The complications of decompression surgery range from transient hoarseness to spinal cord injury, with rates ranging from 0.3% to 60%.ConclusionThere is insufficient evidence that individuals with spondylotic spinal cord encroachment are at increased risk of spinal cord injury from minor trauma. Prospective cohort or case-control studies are needed to assess this risk. There is no evidence that prophylactic decompression surgery is helpful in this patient population. Decompression surgery appears to be helpful in patients with cervical myelopathy, but the significant risks may outweigh the unknown benefit in asymptomatic individuals. Thus, broad recommendations for decompression surgery in suspected at-risk individuals cannot be made. Recommendations to individual patients must consider possible unique circumstances.
Highlights
It has been stated that individuals who have spondylotic encroachment on the cervical spinal cord without myelopathy are at increased risk of spinal cord injury if they experience minor trauma
The purpose of this review is to investigate whether the scientific literature can be used to inform the surgical and non-surgical spine specialist regarding how to advise patients who have spondylotic encroachment on the cervical spinal cord in the absence of frank myelopathy
Studies that were deemed relevant were those that investigated the risk of spinal cord injury from minor trauma in patients with pre-existing spondylotic central canal encroachment and those that reported on outcomes and complications to cervical decompression surgery, with or without fusion
Summary
It has been stated that individuals who have spondylotic encroachment on the cervical spinal cord without myelopathy are at increased risk of spinal cord injury if they experience minor trauma. Spondylosis, with the development of osteophytes, occurs as part of the degenerative process This can lead to the development of clinical symptoms in some individuals if the osteophytes impinge on neural structures such as the nerve root or spinal cord. If this encroachment occurs in the lateral recess or lateral canal it can lead to radiculopathy. Matsumoto, et al [1] assessed 497 asymptomatic subjects and found posterior disc protrusion with compression of the spinal cord in 7.6% While this figure was presented in the abstract of the paper, no details were provided as to how this compression was measured. Cord compression without myelopathy has been found on CT myelography [6]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
