Clinical study of cervical myeloradiculopathy with carpal tunnel syndrome, double crush syndrome

摘要

The hypothesis, "double crush syndrome (DCS)", is that neural function could be impaired when single axons, having been compressed in one region, become especially susceptible to damage in another. We retrospectively review our surgical cases with both cervical lesion and carpal tunnel syndrome, i.e., DCS. From January 2001 to January 2005, we have treated 7 patients (Male-4, Female-3, average age-59.9 years old) under the diagnosis of DCS. Cervical lesions were cervical spondylosis in 4 and cervical narrow canal in 3 patients. Peripheral entrapment neuropathy was carpal tunnel syndrome in all 7 cases. Initial operation was performed for cervical lesion in 2, carpal tunnel syndrome in 2, and 3 cases were operated simultaneously. The improvement rate by Neurosurgical Cervical Spine Scale (NCSS) was average 65.8%. The average follow-up period was 18.2 months. Good results can be obtained in 5 cases, and poor results in 2 cases who underwent initial operation under the diagnosis of single lesion. It is well known that a discrepancy between neurological manifestation and neuro-imaging sometimes occurs in cervical lesions, and then DCS should be considered as a possible pathogenetic mechanism.