LUMBAR AND CERVICAL SPONDYLOSIS AND SPONDYLOTIC MYELOPATHY

The problem of chronic spondylitic spinal disease is markedly underrep resented in the literature. The principal focus is on procedures and d iagnostic techniques. It has been suggested that the classic clinical syndromes are rare and that interventional protocols based on them are likely to be inadequate. New diagnostic techniques have revolutionize d the evaluation of patients: magnetic resonance imaging is now the st andard whereas myelography use is being steadily reduced. It is clear that the outcome of spinal surgery for herniated disk, in expert hands , is excellent. Nevertheless, there is an emphasis on minimally invasi ve and percutaneous techniques to try to avoid major surgery, which ha s been the standard. The natural history of these problems is still un derstood incompletely. Long-term follow-ups are generally not availabl e and the value of nearly every form of conservative care remains unpr oven.