progressive degeneration after surgical intervention leading to disease at adjacent levels
Long-term surgical risks include alteration of the mechanical aspects of cervical joint function (e.g., by fusion, partial removal) and possibly increasing the pace of degeneration by transferring stress to adjacent segments.
Once a single level is surgically treated for symptoms, the patient has a much higher risk of developing long-term progression at adjacent levels or instability at previously treated levels. The only method to prevent this would be multilevel fusion, but this results in significant loss of motion. Adjacent levels can always deteriorate.
acute myelopathy or quadriplegia
Acute myelopathy occurs in only a very small fraction (<0.1%) of patients with cervical spondylosis, although it can result in quadriplegia. As with any spinal cord injury, care of respiration, skin, bowel function, and bladder function are particularly important. Neurologic function tends to improve over time with rehabilitation. Occasionally, surgical decompression may be indicated.
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