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김영태,이춘성,조용선,염태하 대한척추외과학회 1997 대한척추외과학회지 Vol.4 No.1
Objectives : This study was undertaken to retrospectively analyze the preoperative radiologic evaluation and the result of the treatments of cervical spondylosis. Materials and Methods : We reviewed the clinical and radiological aspects of 45 cervical spondylosis patients who had been managed conservatively and poeratively in Asan Medical Center from September 1989 to May 1995. Preoperative plain radiogrphs and MRI were evaluated with clinical symptoms. Postoperative clinical evaluation was performed according to the Robinson's criteria. Results : On plain lateral radiographs, mean spinal canal diameters were 14.8±2.3, 12.9±1.7㎜, Ravlov ratio were 0,78±0.09, 0.71±0.08 and spondylosis index were 0,85㎜, 1.75㎜ in radiculopathy and myelopathy group respectively. The anterio-posterior compression ratio of spinal cord were 53.1±7.9%, 43.2±7.4% respectively. Conservatively managed 23 radiculopathy patients showed clinically excellent in 18, good in 3 and fair in 2 cases. The 6 radiculopathy patients who received anterior decompression and interbody fusion were excellent in 5 and good in one case. The 9 myelopathy patients who underwent anterior decompression and interbody fusion were excellent in 6, good in one, and fair in 2 cases. Seven myelopathy patients who underwent laminoplasty were excellent in 6 and good in one case. Conclusion : Cervical spondylosis patients who have anterio-posterior spinal canal diameter below 13 ㎜, Pavlow ratio less than 0.8 and spondylosis index more than 1.5 ㎜ on plain radiogram are vulnerable to developing cervical spondylotic myelopatgy. It is better to do anterior decompression kyphoticdeformity of the cervical spine. Otherwise, cervical spondylotic patients who have diffuse spondylotic changes more than 3 segments and narrow spinal canal can be managed using laminoplasty posteriorly.
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