TRAUMATIC SPINAL COMPLICATIONS OF CERVICA L SPONDYLOSIS

Objectives: Cervical spondylotic myelopathy is usually a chronic and p rogressive disease, In a few cases, however, dramatic tetraplegia some times occurs after even minor injury. Methods: We report seven patient s (6 males, 1 female, aged from 41 to 63), who suffered from acute mye lopathy after an injury. Results: In 5 cases, the injury revealed the cervical spondylotic myelopathy, A hyperextension of the cervical spin e was found in 5 cases, The injury was severe in only one case, but th ere was no bony abnormalities, except arthrosis, The most common cause was a fan, In contrast, severe tetraplegia was found in 4 cases, Spon taneous, but incomplete, recuperation occurred in 4 patients, In all 7 cases, CT scan and MRI showed congenital cervical stenosis associated with cervical spondylosis. The level of disco-osteophytic changes was mainly in C4, C5, C6, On TZ-weighted spin-echo image, an increased si gnal intensity was present in the cord of 3 patients, but was not corr elated with the severity of the symptoms, nor with improvement, Surgic al treatment was performed in 6 cases: 3 laminectomies, 3 anterior or antero-lateral approaches, Improvement after operative decompression w as observed in all but one case, even when the motor or sensory defici t persists for more than one year, Motricity of the inferior limbs imp roved better than the other deficits, perhaps because of the location of non-reversible lesions in the spinal gray matter. Conclusion: The a cute medullary syndrome of cervical spondylotic myelopathy is serious and can cause major handicaps, This complication justifies a preventiv e surgical attitude when medullar signs are moderate, and cervical ima gery shows a spondylotic compression of the cord with congenital steno sis.