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Decompression of the cervical spine

As a result of load and degeneration (wear) of disc height loss with the spine can become unstable. The body tries to restore spinal stability by propping reactions. These lead to the so-called spondylarthrosis (thickening of the joints), thickening of the ligamentum flava and forming of osteophytes (support of the vertebral bodies) with the consequences of a narrowing of the spinal canal. This is particularly tragic in the cervical spine, because spinal cord runs in the spinal canal and a narrowing of the spinal canal means it comes directly to an injury of the spinal cord.

Leading symptoms are paralysis of the legs and arms, with walking problems particularly in the dark up to paraplegia with the wheelchair.  The symptoms occur rather slowly, so that the period until the first treatment falls rather takes years. Early symptoms include clumsiness of the hands and misperceptions.

Age peak of the disease is between the 50th and 60th year. The disease is in 75% in phases, in which spontaneous recovery is rare. Most patients experience a worsening of symptoms in the course of the disease (about 5% per year). There are also Akkutverläufe(?)with sudden deterioration due to a minor trauma (e.g. head hit the door posts).

Researches show that the frequency of operations on the cervical spine is at about 55 per 100 000 inhabitants. Due to improved and early diagnosis an annual growth rate by about 10% is expected.

Treatment measures are the extension of the spinal canal from the front, with removal of the intervertebral disks or even entire vertebral body and bridging of defects due to vertebral replacement,  or from behind by the removal of the vertebral arches and stabilization with internal fixation. It is also called a laminoplasty, i.e., an unfolding of the vertebral arches. Which method is ultimately chosen is the surgeon's decision. It has however shown that with short segment stenosis (1-2 vertebrae) and possibly a kyphotic deformity, the surgery is reasonable from the front. For extensive stenosis, surgery is preferable from behind. For elderly patients with mild changes, a conservative symptomatic therapy is possible.