Benini A
Wirbelsäulen- und Rückenmarkschirurgie, Schulthess-Klinik, Zürich.
Praxis (Bern 1994). 1996 Oct 22;85(43):1383-6.
Cervical myelopathy is a condition in which progressive compression of the spinal cord occurs going hand in hand with ongoing degenerative changes of the cervical segment of the spine. The degenerative changes start with a progressive degeneration of the disc, leading to a sometimes very severe narrowing of the cervical canal, mostly by osteophytes growing from the posterior edge of the vertebrae. Surgical decompression of the spinal cord is mandatory, as soon as the lesion is recognizable. In the same age group of patients with cervical myelopathy (i.e. aged between 50 and 70 years), primary degenerative lesions of the spinal cord, such as primary spastic progressive paralysis or amyotrophic lateral sclerosis, can occur. They resemble the cervical myelopathy closely. In that age group, everybody's cervical spine is degenerated to some degree; therefore, patients with primary and not compressive lesions of the spinal cord in the cervical tract are very often unnecessarily operated upon. Even if a pathognomonic neurologic pattern of cervical myelopathy does probably not exist, many of the more frequent symptoms and signs permit to lay out a profile of it, which may help to select the patients suitable for surgery as well as to avoid unnecessary and dangerous operations.
脊髓型颈椎病是一种脊髓逐渐受压的疾病，同时伴有颈椎节段的持续退行性改变。退行性改变始于椎间盘的逐渐退变，导致颈椎管有时非常严重的狭窄，主要是由于椎体后缘长出的骨赘所致。一旦病变可识别，脊髓减压手术是必要的。在同一年龄组的脊髓型颈椎病患者（即年龄在50至70岁之间）中，可能会出现脊髓的原发性退行性病变，如原发性痉挛性进行性麻痹或肌萎缩侧索硬化症。它们与脊髓型颈椎病非常相似。在那个年龄组中，每个人的颈椎都有一定程度的退变；因此，患有颈椎段脊髓原发性而非压迫性病变的患者常常被不必要地进行手术。即使可能不存在脊髓型颈椎病的特征性神经学模式，但许多较常见的症状和体征仍可勾勒出其特征，这可能有助于选择适合手术的患者，并避免不必要和危险的手术。
