Gregorius F K, Estrin T, Crandall P H
Arch Neurol. 1976 Sep;33(9):618-25. doi: 10.1001/archneur.1976.00500090024005.
The natural history of cervical spondylotic myelopathy in a series of 55 patients resulted in a moderate to severe disability during a mean period of 45 months. Results of operation for myelopathy indicated improvement in one group that was maintained for a mean of 85 months. In another group, progressive worsening occurred after operation, or late worsening occurred, in some instances as long as 8 to 12 years after improvement and plateau. Patients with cervical spondylotic radiculopathy tended to be separated from those with myelopathy with respect to presentation, symptom complex, and operative result. Results of operation for radiculopathy were consistently good. A worsened disability postoperatively for patients with cervical spondylotic myelopathy was associated with the preoperative symptom of sphincter disturbance and the sign of lower extremity weakness. Change in hand movement after operation for myelopathy and change in distance walking ability were not correlated with numerous preoperative factors. A trend of improvement in disability following anterior interbody fusion and a tendency to worsen in disability following all varities of laminectomy were significant.
55例脊髓型颈椎病患者的自然病史显示，在平均45个月的时间里出现了中度至重度残疾。脊髓病手术结果表明，一组患者病情改善，并持续了平均85个月。在另一组中，术后出现病情逐渐恶化，或出现晚期恶化，在某些情况下，病情改善并稳定后长达8至12年仍会恶化。脊髓型颈椎病神经根病患者在临床表现、症状组合和手术结果方面往往与脊髓病患者有所不同。神经根病手术结果一直良好。脊髓型颈椎病患者术后残疾加重与术前括约肌功能障碍症状和下肢无力体征有关。脊髓病手术后手部运动变化和步行距离能力变化与众多术前因素无关。前路椎间融合术后残疾有改善趋势，各种椎板切除术后残疾有恶化趋势，差异有统计学意义。
