Spinal operations were performed on 4 cases with Amyotrophic Lateral Sclerosis (ALS), in which 3 cases were wrongly diagnosed with cervical spondylotic myelopathy, 1 with L4 degenarative spodylolisthsis, and 1 with L1/2 disc herniation. (In 1 case, operation was performed two times for cervical lesion and lumbar lesion.) The chief complaint of all cases with obvious sensory disturbance, were muscle weakness, dullness, and numbness of the extremity. Sensory disturbance and MRI/CTM showed spinal compression slightly presenting spondylotic degenerative change were misdiagnosed. We must be careful in the evaluation of cases who have simultaneously spondylotic degenerative lesion and ALS. In all cases, post-operational symptoms were worse than pre-operational itself. We believe that the operation deteriorated the neurological states progressively and gave no benefit. In conclusion, spinal disease, with ALS or those for which ALS cannot be ruled out should not be operated.
