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Degenerative cervical spine disease may not progress over time
Date:2/19/2013

een vertebraein several patients. However, during follow-up, none of the patients had further progression, defined as additional displacement of two millimeters or more. The average progression was only about one-half millimeter.

Twenty-one patients had backward displacement ("retrolisthesis") of the cervical vertebrae, while six had forward displacement ("anterolisthesis"). The patients with retrolisthesis had somewhat greater slippage during follow-up; however, none had a dislocation or suffered neurological damage.

No Progression of 'Slippage' or Symptoms

Of 16 patients who had symptoms such as neck pain or sensory abnormalities at the initial visit, most were successfully managed without surgery. Of the 11 patients who were initially symptom-free, none developed symptoms during follow-up.

The study is one of the few to look at the "natural history" of cervical spondylolisthesis. The results suggest that, at medium-term follow-up, the conditions appears to be "relatively stable" in most patients. Dr Park and colleagues write, "This begs the question, if an 'unstable' listhesis does fine without treatment, is it really unstable? Our results suggest that the majority of these patients may be stable and do not develop progression of disease or catastrophic neurologic deficits."

The researchers acknowledge some important limitations of their studyparticularly the small number of patients and relatively short follow-up. However, the results suggest that, for many patients, cervical spondylolisthesis is a non-progressive condition that does not necessarily require surgical treatment. Dr Park and coauthors conclude, "In the absence of neurologic symptoms, we recommend observation of patients with degenerative spondylolistheses of the cervical spine."


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Contact: Connie Hughes
connie.hughes@wolterskluwer.com
646-674-6348
Wolters Kluwer Health
Source:Eurekalert

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