Neural Complications of Cervical Spondylosis: Their Response to Laminectomy and Foramenotomy

Abstract

S PONDYLOSIS of the cervical spine as a cause of nerve-root and spinal-cord compression has been well documented. 2,5,7,15,19 However, few detailed reports of the course of this disease have appeared in the literature. 5,7 Many operative procedures have been employed when conservative measures have failed to arrest progression of neurologic deficit. Such reports have emphasized operative technique and observations.l,S,~l,14,16,20,21,24,26 Others have reported neurologic or neuropathologic findings without a detailed consideration of changing neurologic deficit and symptoms following operative intervention?,4,6,'5,~s,19 We wish to evaluate the course of this disease in 49 patients before and following cervical decompressive laminectomy and foramenotomy. Our intention is to emphasize the difficulties we have encountered in the management of these patients. By so doing we would wish to be able to identify specific circumstances in which this form of management m a y require modification. No pat ient was able to work prior to surgical intervention. All were severely handicapped by progressive neurologic deficit despite vigorous conservative management . Th i r ty of these patients are now able to work.