Guadarrama-Ortiz Parménides, Ruíz-Rivero César Osvaldo, Capi-Casillas Deyanira, Román-Villagómez Alondra, Prieto-Rivera Ángel Daniel, Choreño-Parra José Alberto
Department of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, Mexico
Department of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, Mexico.
Int J Spine Surg. 2023 Oct;17(5):670-677. doi: 10.14444/8520. Epub 2023 Jul 17.
Limited literature exists regarding the differences in demographics, causes, comorbidities, presentation, and structural changes associated with cervical spine degeneration in patients from distinct geographic regions. The authors aimed to evaluate the demographic and clinical characteristics of patients with cervical spine degeneration admitted to a single center in Mexico.
This study enrolled patients with degenerative disease of the cervical spine. Clinical data were retrieved from medical records and retrospectively characterized.
A total of 50 patients with cervical spine degeneration were included in the analysis. Of these, 26% were men with a median age of 54 years. Hypertension, depression, anxiety, obesity, and alcohol consumption were presented in about a quarter of the participants. In addition, we observed hypertriglyceridemia and hypercholesterolemia in 72% and 46% of participants, respectively. The median duration of symptoms was 11 months, including radicular arm/neck pain (80%), tingling (80%), reduced muscle strength (48%), and gait disturbances (48%). Forty percent of patients had 2 cervical segments radiologically involved, mainly at C5-C6, with changes such as disc herniation (88%), foraminal stenosis with nerve root compression (67%), reduced spinal canal-to-vertebral body ratio (38%), and ligamentum flavum hypertrophy (24%). Also, 22% of patients showed degenerative cervical myelopathy. Strikingly, 48% of enrolled individuals showed cervicolumbar tandem spinal stenosis, mainly in L4-L5 and L5-S1, who were generally older, had a longer duration of symptoms, and had a higher comorbidity burden, including hyperglycemia, hypertension, and depression.
The demographic and clinical characteristics of degenerative cervical spine disease in Mexico differ with respect to other geographical regions by a younger age of diagnosis, a high frequency of cardiovascular, metabolic, and mental health comorbidities, and an increased prevalence of concomitant lumbar spinal stenosis.
Our findings reveal a considerably high burden of cervicolumbar tandem spinal stenosis as a distinctive feature of Mexican patients with cervical spine degeneration.
关于不同地理区域患者颈椎退变在人口统计学、病因、合并症、临床表现及结构变化方面的差异，相关文献有限。作者旨在评估墨西哥一家单一中心收治的颈椎退变患者的人口统计学和临床特征。
本研究纳入颈椎退行性疾病患者。从病历中检索临床资料并进行回顾性分析。
共有50例颈椎退变患者纳入分析。其中，26%为男性，中位年龄54岁。约四分之一的参与者患有高血压、抑郁症、焦虑症、肥胖症且有饮酒习惯。此外，我们分别在72%和46%的参与者中观察到高甘油三酯血症和高胆固醇血症。症状的中位持续时间为11个月，包括神经根性手臂/颈部疼痛（80%）、刺痛（80%）、肌肉力量减弱（48%）和步态障碍（48%）。40%的患者有两个颈椎节段影像学受累，主要在C5 - C6，出现椎间盘突出（88%）、伴有神经根受压的椎间孔狭窄（67%）、椎管与椎体比值降低（38%）以及黄韧带肥厚（24%）等变化。此外，22%的患者表现为退行性颈椎脊髓病。引人注目的是，48%的入选个体表现为颈腰椎串联性椎管狭窄，主要在L4 - L5和L5 - S1，这些患者通常年龄较大、症状持续时间较长且合并症负担较高，包括高血糖、高血压和抑郁症。
墨西哥颈椎退行性疾病的人口统计学和临床特征与其他地理区域不同，表现为诊断年龄较轻、心血管、代谢和心理健康合并症发生率高以及伴发腰椎椎管狭窄的患病率增加。
我们的研究结果揭示了颈腰椎串联性椎管狭窄负担相当高，这是墨西哥颈椎退变患者的一个显著特征。
