Department of Orthopaedic Surgery, Nishitaga National Hospital, Sendai, Japan.
Ups J Med Sci. 2011 May;116(2):129-32. doi: 10.3109/03009734.2011.551932. Epub 2011 Feb 18.
To investigate clinical-radiological features of cervical myelopathy due to degenerative spondylolisthesis (DSL).
A total of 448 patients were operated for cervical myelopathy at Nishitaga National Hospital between 2000 and 2003. Of these patients, DSL at the symptomatic disc level was observed in 22 (4.9%) patients. Clinical features were investigated by medical records, and radiological features were investigated by radiographs.
Disc levels of DSL were C3/4 in 6 cases and C4/5 in 16 cases. Distance of anterior slippage was 2 to 5 mm (average 2.9 mm) in flexion position. Space available for the spinal cord (SAC) was 11 to 15 mm (average 12.8 mm) in flexion position and 11 to 18 mm (average 14.6 mm) in extension position; 11 cases were reducible and 11 cases were irreducible in extension position. Myelograms demonstrated compression of spinal cord by the ligamentum flavum in extension position. Compression of spinal cord was not demonstrated in flexion position. C5-7 lordosis angle was lower than control. C5-7 range of motion (ROM) was reduced compared to controls. These alterations were statistically significant.
DSL occurs in the mid-cervical spine. Lower cervical spine demonstrated restricted ROM and lower lordosis angle. Pathogenesis of cervical myelopathy due to DSL is compression of spinal cord by the ligamentum flavum in extension position and not by reduced SAC in flexion position.
研究退行性脊椎滑脱（DSL）所致颈椎脊髓病的临床-影像学特征。
2000 年至 2003 年，我们在西谷田国立医院对 448 例颈椎脊髓病患者进行了手术治疗。其中，在有症状的椎间盘水平观察到 DSL 的患者有 22 例（4.9%）。通过病历调查临床特征，通过 X 线片调查影像学特征。
DSL 的椎间盘水平为 C3/4 6 例，C4/5 16 例。屈伸位时前缘滑移距离为 2 至 5 毫米（平均 2.9 毫米）。屈伸位时脊髓可利用空间（SAC）为 11 至 15 毫米（平均 12.8 毫米），伸展位为 11 至 18 毫米（平均 14.6 毫米）；11 例可复位，11 例不可复位。伸展位时脊髓造影显示黄韧带对脊髓的压迫。在屈曲位时未显示脊髓受压。C5-7 颈椎前凸角低于对照组。与对照组相比，C5-7 活动范围（ROM）减少。这些变化具有统计学意义。
DSL 发生在颈椎中段。下位颈椎活动范围受限，颈椎前凸角降低。DSL 所致颈椎脊髓病的发病机制是伸展位黄韧带对脊髓的压迫，而不是屈曲位 SAC 减少。
