Decompressive Cervical Surgery and Hypertension

Study Overview
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Brief Summary
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There is a relationship between CSM and hypertension, probably a cause/effect relationship, and investigators term this type of hypertension cervicogenic hypertension. Abnormally functioning serotonergic pacemaker cells in the dorsal raphe nucleus inappropriately activate and inhibit parts of the central and autonomic nervous systems as part of a chronic stress response, which causes hypertension and migraine. This theory is now being expanded to encompass both CSM and essential hypertension, the idea being that these two conditions are intimately related.

Detailed Description
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Cervical spondylotic myelopathy (CSM) and hypertension are both very common diseases in the general population.Investigators have also observed previously hypertensive patients with CSM become normotensive following decompressive cervical surgery and no longer need antihypertensive medications. Both observations are difficult to explain according to current theories of the two diseases.

Official Title
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Decompressive Cervical Surgery for Antihypertensive Effect in Patients With Cervical Spondylosis and Hypertension-A Cohort Study

Conditions
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Myelopathy, Compressive, Hypertension

Intervention / Treatment
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* Procedure: decompressive cervical surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Established diagnosis of cervical spondylosis myelopathy Be at least 18 years of age Office-measured systolic BP≧140mmHg Ability to adhere to study protocol Have signed an approved informed consent form for participation in this study Exclusion Criteria: Have hypertension secondary to a treatable cause Have prior cervical spine surgery Are pregnant or contemplating pregnancy during the 3-month follow-up period People deny to join the study Are unable to comply with protocol requirements Are unlikely to survive the protocol follow-up period Are enrolled in another concurrent clinical trial Visual Analogue Scale≥4

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 84 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| operation<br>To make decompressive cervical surgery, either anterior cervical discectomy and fusion or posterior laminoplasty on the patients suffering from cervical spondylotic myelopathy and hypertension. | Procedure: decompressive cervical surgery<br>* To make decompressive cervical surgery, either anterior cervical discectomy and fusion or posterior laminoplasty on the patients suffering from cervical spondylotic myelopathy and hypertension.<br>* Other names: posterior laminoplasty;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in the systolic blood pressure(SBP) measured by 24-hour Ambulatory Blood Pressure Monitoring(ABPM) on 1st month and 3th month post-operation. |  | twice ABPM prior to operation and 1st month, 3th month post-operation. |