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SURGERY OF THE CERVICAL SPINE FOR COMPRESSION AT AN ASYMPTOMATIC LEVEL



Abstract

Objective: Radicular symptoms of the cervical spine are usually effectively managed by cervical decompressive surgery when the symptomatic nerve root corresponds to the level of maximal radiological compression. The response is less predictable when the symptomatic level and the level of radiological compression are mismatched. The aim of this study was to retrospectively assess the efficacy of surgery in cases where symptom level and the level of radiological compression were mismatched.

Design: We conducted a casenote review of patients who underwent cervical decompressive surgery for radicular symptoms over a five year period with an average follow-up period of 3.5 years.

Subjects’ outcome: Three hundred and thirty-nine patients underwent cervical decompression during this period. Of these, 76 had surgery for isolated radicular symptoms. Nineteen of these patients had radiological and symptomatic mismatch.

Results: Seventy-five percent of those with mismatch initially had a good response to surgery, but 31% subsequently required a further operation. Comparable figures for those whose symptoms and radiology matched are 63% and 6%.

Conclusions: Patients who have radicular symptoms, which do not correspond to the level of radiological compression, do benefit from surgical decompression, but have an increased likelihood of requiring a second operation.

Abstracts prepared by Mr. A. J. Stirling, FRCS, and Miss A. Weaver. Correspondence should be addressed to Miss A. Weaver at the Research and Teaching Centre, Royal Orthopaedic Hospital, Northfield, Birmingham, B31 2AP, UK

BritSpine 2002, the second combined meeting of the British Association of Spinal Surgeons, the British Cervical Spine Society, The British Scoliosis Society and the Society for Back Pain Research, took place at the International Convention Centre in Birmingham UK between 27th February and 1st March 2002. The following presentations and posters were given and displayed.

References:

1 Grieve JP, Kitchen ND, Moore AJ, Marsh H. Results of posterior cervical foraminotomy for treatment of cervical spondylitic radiculopathy. Br. J. Neurosurgery2000 Feb; 14(1): 40–3. Google Scholar

2 Witzmann A, Hejazi N, Krasznai L. Posterior cervical foraminotomy. A follow-up study of 67 surgically treated patients with compressive radiculopathy. Google Scholar