Klineberg Eric
Adult and Pediatric Spinal Surgery, Department of Orthopaedics, 4860 Y Street, Suite 3800, Sacramento, CA 95817, USA.
Orthop Clin North Am. 2010 Apr;41(2):193-202. doi: 10.1016/j.ocl.2009.12.010.
Cervical spondylotic myelopathy (CSM) is the most common progressive spinal cord disorder in patients more than 55 years old. This disease is also the most common cause of acquired spasticity in later life and may lead to progressive spasticity and neurologic decline. This article explores some of the controversies about CSM and reviews pertinent articles, specifically prospective and randomized clinical trials when possible, to obtain the cleanest and least biased data. The 4 current controversial topics that surround CSM are: (1) natural history of mild CSM; (2) surgical approach: anterior versus posterior; (3) laminoplasty or laminectomy; and (4) cervical arthroplasty for CSM.
脊髓型颈椎病（CSM）是55岁以上患者中最常见的进行性脊髓疾病。该疾病也是晚年获得性痉挛最常见的原因，可能导致进行性痉挛和神经功能衰退。本文探讨了有关脊髓型颈椎病的一些争议，并回顾了相关文章，尽可能具体地回顾前瞻性和随机临床试验，以获取最清晰、偏差最小的数据。目前围绕脊髓型颈椎病的4个有争议的话题是：（1）轻度脊髓型颈椎病的自然史；（2）手术方式：前路与后路；（3）椎板成形术或椎板切除术；（4）脊髓型颈椎病的颈椎关节成形术。
