Zusammenfassung
Die Kompression des Rückenmarks im zervikalen Spinalkanal ist die häufigste Myelopathie des höheren Lebensalters. Häufig besteht eine angeborene Prädisposition in Form eines engen Spinalkanals. Das Hinzutreten erworbener Faktoren, in Form von Spondylophyten, Verkalkung des hinteren Längsbandes oder seltener eines Bandscheibenvorfalles, führt zur myelopathischen Symptomatik. Leitsymptom ist eine langsam zunehmende spastische Gangstörung, kombiniert mit sensiblen Störungen an den Beinen. An den oberen Extremitäten imponiert die Störung der Feinmotorik der Finger. Häufig ist die zervikale Myelopathie mit einer zervikalen Radikulopathie kombiniert. Der Verlauf ist chronisch, Tempo und Ausmaß der Progredienz sind sehr variabel. Die Operationsindikation und Operationsmethode hängt ab von Befundkonstellation, Verlauf, Alter und Allgemeinzustand des Patienten. Je nach Ausdehnung der spinalen Stenose stehen operative Verfahren mit anteriorem oder posteriorem Zugang zur Verfügung.
Similar content being viewed by others
Literatur
Asai J, Hayashi T, Fujimoto T, Suzuki R (2001) Exclusively epidural arteriovenous fistula in the cervical spine with spinal cord symptoms: case report. Neurosurgery 48:1372–1375
Asakawa H, Yanaka K, Fujita K, Marushima A, Anno I, Nose T (2002) Intracranial dural arteriovenous fistula showing diffuse MR enhancement of the spinal cord: case report and review of the literature. Surg Neurol 58:251–257
Azuma S, Seichi A, Ohnishi I, Kawaguchi H, Kitagawa T, Nakamura K (2002) Long-term results of operative treatment for cervical spondylotic myelopathy in patients with athetoid cerebral palsy: an over 10-year follow-up study. Spine 27:943–948
Böhm H, Greiner-Perth R, El-Saghir H, Allam Y (2003) A new minimally invasive posterior approach for the treatment of cervical radiculopathy and myelopathy: surgical technique and preliminary results. Eur Spine J 12:268–273
Bruhl K, Stoeter P, Wietek B, Schwarz M, Humpl T, Schumacher R, Spranger J (2001) Cerebral spinal fluid flow, venous drainage and spinal cord compression in achondroplastic children: impact of magnetic resonance findings for decompressive surgery at the cranio-cervical junction. Eur J Pediatr 160:10–20
Davies BM, Mowforth OD, Smith EK, Kotter MRN (2018) Degenerative cervical myelopathy. BMJ 360:k186. https://doi.org/10.1136/bmj.k186. PMCID: PMC6074604
Emery SE (2001) Cervical spondylotic myelopathy: diagnosis and treatment. Am Acad Orthop Surg 9:376–388
Epstein N (2002) Posterior approaches in the management of cervical spondylosis and ossification of the posterior longitudinal ligament. Surg Neurol 58:194–207
Fehlings MG, Wilson JR, Kopiar B, Yoon ST, Arnold PM, Massicotte AM et al (2013) Efficacy and safety of surgical decompression in patients with cervical spondylotic myelopathy: results of the AOSpine North America prospective multi-center study. J Bone Joint Surg Am 95(18):1651–1658
Fouyas IP, Statham PF, Sandercock PA, Lynch C (2001) Surgery for cervical radiculomyelopathy. Cochrane Database Syst Rev 3:CD001466
Furumoto T, Nagase J, Takahashi K, Itabashi T, Iai H, Ishige N (1996) Cervical myelopathy caused by the anomalous vertebral artery. A case report. Spine 21:2280–2283
Geck MJ, Eismont FJ (2002) Surgical options for the treatment of cervical spondylotic myelopathy. Orthop Clin North Am 33:329–348
Hamburger C, Lanksch W, Oeckler R, Bachmann C (1994) The treatment of spondylotic cervical myelopathy by ventral discectomy. Long term results on 121 patients. Neurosurg Rev 17:247–252
Herdmann J, Linzbach M, Krzan M (1994) The European myelopathy score. In: Baucher BL, Brock M, Klinger M (Hrsg) Advances in neurosurgery. Springer, Berlin, S 266–268
Iwasaki M, Yamamoto T, Miyaguchi A, Amano K, Yonenobu K (2002) Cervical kyphosis: predictive factors for progression of kyphosis and myelopathy. Spine 27:1419–1425
Kadanka Z, Mares M, Bednanik J, Smrcka V, Krbec M, Stejskal L, Chaloupka R, Surclova D, Novotny O, Urbanek I, Dusek L (2002) Approaches to spondylotic cervical myelopathy: conservative versus surgical results in a 3-year follow-up study. Spine 27:2205–2210
Krauss JK, Jankovic J (1996) Severe motor tics causing cervical myelopathy in Tourette’s syndrome. Mov Disord 11:563–566
Kubota M, Saeki N, Yamamaura A, Yamamoto Y, Nemoto Y, Fukutake T (2003) Congenital spondylolysis of the axis with associated myelopathy. Case report. J Neurosurg 98:84–86
Lawrence BD, Jacobs WB, Norvell DC, Hermsmeyer JT, Chapmann JR, Brodke DS (2013) Anterior versus posterior approach for treatment of cervical spondylotic myelopathy. Spine 38(22S):173–182
Leung C, Casey AT, Goffin J, Kehr P, Liebig K, Lind B, Logroscino C, Pointillart V (2005) Clinical significance of heterotopic ossification in cervical disc replacement: a prospective multicenter clinical trial. Neurosurgery 57(4):759–763; discussion 759–63
Macdonald RL, Fehlings MG, Tator CH, Lozano A, Fleming JR, Gentili F, Bernstein M, Wallace MC, Tasker RR (1997) Multilevel anterior cervical corpectomy and fibular allograft fusion for cervical myelopathy. J Neurosurg 86:990–997
Padua L, Padua R, LoMonaco M, Tonali PA (1996) Radiculo medullary complications of cervical spinal manipulation. Spinal Cord 34:220–226
Ratliff JK, Cooper PR (2003) Cervical laminoplasty: a critical review. J Neurosurg 98:230–238
Shamji M, Ames CP, Smith JS, Rhee JM, Chapman JR, Fehlings MG (2013) Myelopathy and spinal deformity. Spine 38(22S):S147–S148
Stevinson C, Honan W, Cooke B, Ernst E (2001) Neurological complications of cervical spine manipulation. J R Soc Med 94:107–110
Yamamoto A, Nishiura I, Handa H, Kondo A (2001) Ganglion cyst in the ligamentum flavum of the cervical spine causing myelopathy: report of two cases. Surg Neurol 56:390–395
Young WF (2000) Cervical spondylotic myelopathy: a common cause of spinal dord dysfunction in older persons. Am Fam Physician 62:1064–1070
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature
About this entry
Cite this entry
Henningsen, H., Papavero, L. (2019). Zervikale Myelopathie. In: Berlit, P. (eds) Klinische Neurologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44768-0_73-1
Download citation
DOI: https://doi.org/10.1007/978-3-662-44768-0_73-1
Received:
Accepted:
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-44768-0
Online ISBN: 978-3-662-44768-0
eBook Packages: Springer Referenz Medizin