Cervical spondylosis is a common disease among middle-aged and elderly people, and authoritative statistics show that the prevalence rate reaches 25% for people over 50 years old and 50% for people over 60 years old. Patients with severe cervical spondylosis need to be treated by surgery. However, many patients in clinical work have a fear of surgery, believing that surgery of the cervical spine is risky and has the risk of leading to paralysis. It is not known that the risk of paralysis from cervical spondylosis itself is significantly higher than the risk of surgical treatment. The following is the treatment of a patient with cervical spondylosis, prompting the majority of patients to be alert to cervical spondylosis and accept the treatment recommendations of their doctors whenever possible. Chen Zan, Department of Neurosurgery, Xuanwu Hospital, Capital Medical University
The male patient was 65 years old and had been seen at the local hospital for cervical discomfort one year before the onset of the disease. CT of the cervical spine indicated calcification of the posterior longitudinal ligament and cervical spinal stenosis, as follows
Figure 1 The patient’s cervical spine CT showed calcification of the posterior longitudinal ligament and severe stenosis of the cervical spinal canal
The local hospital recommended the patient to undergo surgery, but the patient did not accept the surgical treatment recommendation and was treated conservatively. One day before he was admitted to our hospital, he accidentally fell down. He developed symptoms such as weakness of the limbs and dysfunction of urination and defecation. He came to our hospital and underwent an emergency cervical MRI, which revealed acute cervical medullary injury. The following figure.
Figure 2 MRI of the patient’s cervical spine showed that the patient’s spinal cord was significantly compressed and the spinal cord was severely injured
After we improved the preoperative examination, a single-opening spinal canal enlargementplasty was performed on an emergency basis. Postoperative reexamination of CT and MRI is shown in the figure below, which shows that the diameter of the cervical spinal canal was enlarged and the spinal cord compression was completely released. The patient resumed self-care after short-term rehabilitation.
Figure 3 Postoperative cervical spine CT of the patient, showing the enlarged cervical spinal canal of the patient
Figure 4 Postoperative MRI of the cervical spine showing complete release of spinal cord compression
Case summary: Patients with spinal cord cervical spondylosis are easily ignored by patients because of the mild symptoms. However, the potential risk of the disease is great and may lead to catastrophic paraplegia after a minor trauma to the patient. Therefore, patients are advised to accept the treatment recommendations of their doctors to avoid leaving regrets. Our Xuanwu Hospital has achieved good results in the treatment of cervical spinal stenosis by using the unique cervical single-opening spinal canal enlargement procedure