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首页> 外文期刊>Journal of clinical neuroscience: official journal of the Neurosurgical Society of Australasia >Is cervical decompression beneficial in patients with coexistent cervical stenosis and multiple sclerosis?
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Is cervical decompression beneficial in patients with coexistent cervical stenosis and multiple sclerosis?

机译：颈椎狭窄合并多发性硬化症患者的颈椎减压治疗是否有益？

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Cervical stenosis (CS) and multiple sclerosis (MS) are two common conditions with distinctive pathophysiology but overlapping clinical manifestations. The uncertainty involved in attributing worsening symptoms to CS in patients with MS due to extremely high prevalence of asymptomatic radiological CS makes treatment decisions challenging. A retrospective review was performed analyzing the medical records of all patients with confirmed diagnosis of MS who had coexistent CS and underwent surgery for cervical radiculopathy/myeloradiculopathy. Eighteen patients with coexistent CS and MS who had undergone cervical spine decompression and fusion were identified. There were six men and 12 women with an average age of 52.7 years (range 40-72 years). Pre-operative symptoms included progressive myelopathy (14 patients), neck pain (seven patients), radiculopathy (five patients), and bladder dysfunction (seven patients). Thirteen of the 14 patients (92.9%) with myelopathy showed either improvement (4/14, 28.6%) or stabilization (9/14, 64.3%) in their symptoms with neck pain and radiculopathy improving in 100% and 80% of patients, respectively. None of the seven patients with urinary dysfunction had improvement in urinary symptoms after surgery. To conclude, cervical spine decompression and fusion can improve or stabilize myelopathy, and significantly relieve neck pain and radiculopathy in the majority of patients with coexistent CS and MS. Urinary dysfunctions appear unlikely to improve after surgery. The low rate of surgical complications in our cohort demonstrates that cervical spine surgery can be safely performed in carefully selected patients with concomitant CS and MS with a good clinical outcome and also eliminate CS as a confounding factor in the long-term management of MS patients. 2014 Elsevier Ltd. All rights reserved.
机译：宫颈狭窄（CS）和多发性硬化（MS）是两种常见的病状，病理生理特征独特，但临床表现重叠。由于无症状放射学CS的极高患病率，导致MS患者将症状恶化归因于CS的不确定性使治疗决策具有挑战性。进行了回顾性分析，分析了所有确诊为MS并合并CS并接受了颈椎神经根病/脊髓神经根病手术治疗的MS患者的病历。确定了18例CS和MS并存的颈椎减压和融合患者。男6例，女12例，平均年龄52.7岁（40-72岁）。术前症状包括进行性脊髓病（14例），颈部疼痛（7例），神经根病（5例）和膀胱功能障碍（7例）。 14例脊髓病患者中有13例（92.9％）症状有所改善（4/14，28.6％）或稳定（9/14，64.3％），颈部疼痛和神经根病的缓解率分别为100％和80％，分别。七名泌尿功能障碍患者术后无一例泌尿症状有所改善。总而言之，对于大多数CS和MS并存的患者，颈椎减压和融合可以改善或稳定脊髓病，并显着缓解颈部疼痛和神经根病。术后尿功能障碍似乎不太可能改善。在我们的队列中，手术并发症的发生率低表明，颈椎手术可以在精心挑选的伴有CS和MS的患者中安全地进行，并具有良好的临床效果，并且消除了CS作为MS患者长期治疗中的混杂因素。 2014 Elsevier Ltd.保留所有权利。

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