Maestre-Moreno J F, Fernández-Pérez M D
Servicio de Neurología, Hospital Universitario Virgen de las Nieves, Granada, 18013, España.
Rev Neurol. 2002;34(11):1087-91.
From the data available in the literature, to analyse the natural history of acute or chronic radiculopathies and myelopathies linked with degenerative disease of the cervical spine.
By means of different electronic and manual search methods, we located original pieces of work dealing with recent objectives and reviews on the subject. We have attempted to take into account any data that might be relevant, regardless of the characteristics or quality of the work in which it was published. The high prevalence of degenerative changes in the cervical region in the general population, the fact that the development of the concept of cervical radiculopathies and myelopathies has gone parallel to the development of their surgical treatment, and that there are few series with a control group and independent evaluation and no trials with random assignation do not allow a systematic approach. The anatomical and radiological aspects of cervical arthrosis are well known, but there is little information available on the causal relation between both processes and their clinical translation or their natural evolution.
In the present state of knowledge, it is not possible to establish unmistakable relations between cervical disc disease and the radiculopathies and myelopathies it is attributed with. The natural evolution of these neurological syndromes is not known and therefore neither is it known how this could be modified by conservative or surgical treatment. From critical points of view, there is a unanimous claim for clinical trials to be performed with random assignation, which would provide us with an understanding of the natural history of these entities and the role of the different surgical or conservative treatments available
根据文献中的现有数据，分析与颈椎退行性疾病相关的急性或慢性神经根病和脊髓病的自然史。
通过不同的电子和手工检索方法，我们找到了涉及近期目标和该主题综述的原创性研究。我们试图考虑任何可能相关的数据，无论其发表的研究的特征或质量如何。由于普通人群中颈椎区域退行性改变的高患病率，颈椎神经根病和脊髓病概念的发展与其手术治疗的发展并行，且很少有研究设置对照组和进行独立评估，也没有随机分配的试验，因此无法采用系统的方法。颈椎关节病的解剖学和放射学方面已为人熟知，但关于这两个过程之间的因果关系及其临床转化或自然演变的信息却很少。
就目前的知识水平而言，无法确定颈椎间盘疾病与其所导致的神经根病和脊髓病之间的确切关系。这些神经综合征的自然演变尚不清楚，因此也不知道保守或手术治疗如何对其进行改变。从批判性的角度来看，人们一致要求进行随机分配的临床试验，这将使我们了解这些疾病的自然史以及现有不同手术或保守治疗的作用。
