[Surgical outcome of cervical flexion myelopathy in young adults]

We encountered five young male patients with cervical flexion myelopathy, and treated them all surgically. Symptoms were first noted at 15 to 18 years of age (mean: 16.6 years), and their ages at the time of admission to our hospital, ranged from 19 to 25 years old (mean: 20.8 years). Anterior decompression and fusion of the cervical spine with long bone graft following resection of two vertebrae was performed in three cases. The other two patients were treated by posterior fusion of five laminas (C3-C7) using Rogers' method. In selecting the surgical approach, we favored anterior fusion because it allows removal of anterior structures (vertebral bodies, intervertebral discs or osteophytes) compressing the cervical spinal cord in flexed neck position. Posterior fusion was performed in patients whose anterior structures compressing the cervical spinal cord extended over a wide area. Postoperative improvement of muscle weakness was observed in four patients, and sensory disturbance was alleviated in the remaining patient. However, the abnormal deep tendon reflexes and muscle atrophy in the upper extremities observed in all of the patients preoperatively improved in only two of them. Thus, all of the patients showed some neurological improvement, and surgical fusion of the cervical spine appeared to be an effective means of treating cervical flexion myelopathy in young adults. Both the anterior and the posterior approach were useful in treating cervical flexion myelopathy, but it was impossible to conclude which approach is more effective based on this small number of cases.(ABSTRACT TRUNCATED AT 250 WORDS)