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307708

Conservative Treatment of Cervical Discs without Myelopathy: A Three Years Follow-up

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Last updated: 01 Jan 2025

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Abstract

Abstract Background: The natural course of disc prolapsed in the cervical region is not fully known, and clear indications for operative intervention apart from obvious weakness or radio-logical evidence of cord injury, cannot be established from the literature. Several works and reviews had demonstrated that most massive lumbar disc prolapse are the most likely to resolve, and still no enough studies about prolapsed cervical discs. Aim of Study: This study was designed to determine whether large lateral cervical prolapsed discs without mye-lopathy can be safely managed conservatively leading to clinical & radiological improvement. Patients and Methods: We prospectively collected the data from 48 patients followed at outpatient clinic in Cairo University and Bani-Souf University Department of Neuro-surgery from period from march 2011 to March 2014 during this period all cases undergo clinical assessments, magnetic resonance imaging (MRI) and received intermittent medical treatment. Selected patients had severe brachialgia at first presentation but began to show clinical improvement despite the one side disc migration evident on initial imaging. The Karnofsky Scale was used to measure function and changes in performance. Results: Initial follow-up at three and six months showed positive response in 44 patients (91.6%). Follow-up at a 12 months' average revealed that 42 patients (87.5%) had a complete and maintained recovery. Only 6 cases had unsatis-factory progress and need discectomy. The average scoring system to assess disability raised from 60% to 90%. The change that occurred in the volume of extruded disc material decreased of 50% in disc volume. There was no good associ-ation between medical improvement and the degree of disc regression. Conclusion: A large lateral disc material extrusion in the cervical vertebrae treated conservatively can pursue a favorable clinical course. If early improvement is shown, the far timed follow is excellent, and even substantial cervical disc prolapses can be dealt with non-surgically.

DOI

10.21608/mjcu.2023.307708

Keywords

Cervical disc, Conservative, Pain

Authors

First Name

MOHAMED SHABAN, M.D.*;

Last Name

AHMED A. ABDELKHALEK, M.D.**

MiddleName

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Affiliation

The Department of Neurosurgery, Faculties of Medicine, Bani-Souf* and Cairo** Universities

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Volume

91

Article Issue

03

Related Issue

42152

Issue Date

2023-03-01

Receive Date

2023-07-14

Publish Date

2023-03-01

Page Start

403

Page End

407

Print ISSN

0045-3803

Online ISSN

2536-9806

Link

https://mjcu.journals.ekb.eg/article_307708.html

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https://mjcu.journals.ekb.eg/service?article_code=307708

Order

307,708

Type

Original Article

Type Code

263

Publication Type

Journal

Publication Title

The Medical Journal of Cairo University

Publication Link

https://mjcu.journals.ekb.eg/

MainTitle

Conservative Treatment of Cervical Discs without Myelopathy: A Three Years Follow-up

Details

Type

Article

Created At

30 Dec 2024