Feng Shitong, Fan Zihan, Yang Yong, Fei Qi, Li Xiang
Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
Int J Gen Med. 2020 Dec 2;13:1367-1372. doi: 10.2147/IJGM.S288588. eCollection 2020.
The aim of this study was to present a novel case of unilateral proximal cervical spondylotic amyotrophy (CSA) with contralateral spinal cord compression, which is subject to misdiagnosis and missed diagnosis.
CSA is the rare form of cervical spondylosis, which is characterized by severe muscle atrophy in the upper extremities. It can be classified in the proximal subtype and the distal subtype. The etiology, pathophysiology and treatment of CSA are still controversial.
A rare case of atypical proximal CSA, who presented with left shoulder and arm weakness, but cervical magnetic resonance imaging (MRI) showed large right paracentral disc herniation in the C4-5 level. Twelve weeks after undergoing anterior cervical discectomy and fusion technique in C4-5 level, the patient's symptoms obviously recovered.
The opposite sides between disc herniation and clinical symptoms of upper extremity may be attributed to C5 ventral rootlet becoming stretched caused by spinal cord rotation or shift to the opposite side.
本研究旨在呈现一例伴有对侧脊髓受压的单侧近端型颈椎病性肌萎缩（CSA）的新病例，该病例易被误诊和漏诊。
CSA是颈椎病的罕见形式，其特征为上肢严重肌肉萎缩。它可分为近端亚型和远端亚型。CSA的病因、病理生理学及治疗仍存在争议。
一名罕见的非典型近端型CSA病例，表现为左肩和手臂无力，但颈椎磁共振成像（MRI）显示C4 - 5水平右侧巨大中央旁椎间盘突出。在C4 - 5水平进行颈椎前路椎间盘切除融合术后12周，患者症状明显恢复。
椎间盘突出与上肢临床症状之间的对侧关系可能归因于脊髓旋转或向对侧移位导致C5腹侧神经根被牵拉。
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