Surgical treatment of cervical spondylotic amyotrophy

Objective To investigate the clinical characteristics and treatment of cervical spondylotic amyotrophy.Methods 9 cervical spondylotic amyotrophy patients and 15 cervical radiolopathy, myelopathy spondylosis patients were included in this study.Their clinical manifestation,MRI image results and treatment were analysised.Of 9 cervical spondylotic amyotrophy patients,7 cases were done with cervical disectomy,2 cases were done with combined cervical anterior and posterior operation;of 15 radiolopathy,myelopathy spondylosis patients,12 cases were done with cervical disectomy,3 cases were done with combined cervical anterior and posterior operation.Results Cervical spondylotic amyotrophy patients were followed up 6-36 months,muscle power of 9 patients were improved markedly,muscle power of 6 patients were improved from grade Ⅱ preoperation to grade Ⅳ-Ⅴ postoperation after operation 6months, relief rate is 75%-100%,that of 2 patients were improved from grade Ⅲ preoperation to grade Ⅳ-Ⅴ postoperation,relief rate is 50% and 100% respectively,that of 1 patient (multiple segments) wore improved from grade Ⅰ preoperation to grade Ⅲ postoperation,relief rate is 50%;8 patients were followed up over 12 months,muscle power of 7 patients were improved to grade Ⅴ,relief rate is 100%,that of 1 patient were improved to grade Ⅳ,relief rate is 80%.cervical radiolopathy,myelopathy spondylosis patients were followed up 12-36 months,muscle power of 15 patients were improved respectively,muscle power of 15 patients were improved from grade Ⅱ-Ⅳ preoperation to grade Ⅲ-Ⅴ postoperation after operation 6months,relief rate is 20%-100%,all 15 patients were followed up over 12 months,muscle power of 11 patients were improved to grade Ⅴ,relief rate is 100%,that of 3 patient were improved to grade Ⅳ, relief rate is 20%-50%,that of 1 case keep unchanged.Conclusion Cervical spondylotic amyotropby is a rare type of cervical spondylotic disorder,it is easily misdiagnosed because it is confused with motor neuron disease.MRI and electromyography can help to diagnose.The mechanism of cervical spondylotic amyotrophy maybe is that compression of anterior horn of spinal cord or ischemic injury of spinal cord.Surgical treatment can help to improve muscle power,prognosis of single segment is better than that of multiple segments.