Article

Retrospective study. OBJECTIVE: To investigate the progression of
spinal tract lesions in cervical spondylotic myelopathy (CSM) at C3-4
intervertebral level using spinal cord-evoked potensials (SCEPs). SETTING: This
study was conducted at the Department of Orthopaedic Surgery, Yamaguchi
University Graduate School of Medicine, Japan. METHODS: A total of 30 patients
with CSM were investigated in this study. In all patients, only the C3-4
intervertebral level was symptomatic, as shown by examination of SCEPs. SCEPs
were recorded following median nerve stimulation (MN-SCEPs), transcranial
electric stimulation (TES-SCEPs) and spinal cord stimulation (spinal-SCEPs).
RESULTS: The incidence of abnormalities varied in the order of MN-SCEPs (100%),
TES-SCEPs (90%) and spinal-SCEPs (67%). Patients were grouped into three types
according to SCEPs: transverse (all SCEPs abnormal), post-erolateral
(abnormalities in the MN-SCEPs and TES-SCEPs) and upper limbs sensory (abnormal
only for MN-SCEPs). In all, 20 of the 30 patients (67%) were the transverse type,
7 (23%) the post-erolateral type and 3 (10%) the upper limbs sensory type.
CONCLUSION: The present study showed the lateral part of the posterior funiculus
mediating upper limb sensory function was more vulnerable than the lateral
corticospinal tract, which is consistent with numbness tending to appear at an
early stage of mild CSM.

Langue : ANGLAIS