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The cervical stenosis syndrome with a review of 83 patients treated by operation

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Abstract

The cervical stenosis syndrome is defined from clinical considerations and the functional and organic groups are described. A classification of the causes of the syndrome is then discussed and presented in tabular form. Functional stenosis is best treated by conservative measures but organic stenosis requires operation.

The techniques of approach, decompression and anterior fusion are presented in the light of the author's experience with 83 patients. The results of operation in these patients are described.

Résumé

Les syndromes de compression médullaire ou radiculo-médullaire du canal cervical peuvent être fonctionnels et justiciables du traitement médical (2 cas) ou organiques: 81 cas de ceux-ci ont été opérés qu'ils soient congénitaux (2 cas) ou acquis et alors en rapport le plus souvent avec une arthrose dégénérative (59 cas), une tumeur (13 cas), bien plus rarement des séquelles de traumatisme ou de lésions inflammatoires ou infectieuses (2 cas).

Pour affirmer l'origine mécanique des troubles neurologiques très divers, un examen très attentif est nécessaire dans lequel l'examen radiologique avec opacification, artériographie et scannogramme jouent un rôle important.

La décompression a été effectuée en règle par voie antérieure (89 cas) avec arthrodèse par le procédé de Cloward combiné souvent avec avec une uncusectomie partielle. En cas d'atteinte étendue la somectomie subtotale de trois ou quatre vertèbres permet une bonne décompression et une arthrodèse par une greffe iliaque, complétée si nécessaire par plaque vissée. La voie postérieure n'a été employée seule que 10 fois mais combinée 3 fois à la voie antérieure.

Les résultats dans l'arthrose dégénérative ont été excellents ou bons dans 74% des cas, passables dans 10%. Dans les tumeurs bénignes on a eu 6 guérisons sur 7. Six tumeurs malignes ont été temporairement améliorées.

Il faut insister sur la nécessité d'un diagnostic et d'une intervention précoce, en cas de souffrance médullaire.

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Authors and Affiliations

  1. Orthopaedic and Traumatology Clinic, University of Pavia, Policlinico S. Matteo, Via Taramelli, I-27100, Pavia, Italy

    M. Boni & V. Denaro

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  1. M. Boni
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  2. V. Denaro
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Boni, M., Denaro, V. The cervical stenosis syndrome with a review of 83 patients treated by operation. International Orthopaedics 6, 185–195 (1982). https://doi.org/10.1007/BF00267729

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