Clinical investigation of cervical disc lesion without spondylosis.

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From 1977 through 1983, 71 patients were operated on at our hospital. They did not have spondylotic changes, that is, posterior spur formation, narrow foramen or deformities of the Luschka joints. These 71 cases, which included 36 cases with discogenic myelopathy, 31 with discogenic radiculopathy and 4 with local signs, were followed up.Results were as follows:1) Age of onset was 40 years on the average, and that was 15 years younger than that of 111 patients with CSM and CSR who underwent surgery at our hospital.2) The provocative rate was about 33 percent. Traumatic factors were: traffic accidents (7 cases), degradation accidents (5 cases), falling down (4 cases), contusion (2 cases) and sports injuries (1 case).3) The frequencies of the lesion levels were, in order: C5/6 (54.4%), C4/5 (24.8%), C6/7 (14.9%), C3/4 (5.0%) and C7/Th1 (1.0%). This tends to be the same as for cervical spondylotic myelopathy and radiculopathy.4) Narrow disc (56%), instability (54%), retrolisthesis (32%), angulation (22%) on the plain X-P were diagnostic changes of the cervical disc lesion. Clinical signs of these lesions were inclined to occur in the cases that were accompanied by narrow canal and anterior shift of the upper apex in the superior facet.5) Myelography was very valuable as a diagnostic technique to determine the main foous, especially in cases with spondylosis on other levels.6) Operation procedures were Cloward's method (38 cases), Simmons (31 cases) and Smith-Robinson (2 cases). The results of all were excellent. 24 cases (85.7%) of the 28 patients with myelopathy who could be followed up had more than 16 points using JOA standard of CSM.
西日本整形・災害外科学会の論文

Clinical investigation of cervical disc lesion without spondylosis.

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