Cervical spondylotic myelopathy

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By Saul S Schwarz MD

Cervical spondylotic myelopathy is also known as Cervical spinal stenosis. -ed.

In this clinical article, Dr. Saul Schwarz of the University of Colorado Health Sciences and Department of Neurosurgery at Kaiser Permanente in Denver provides an overview of the demographics, clinical presentation, diagnostic evaluation, and treatment of cervical spondylotic myelopathy, a common, frequently painful arthritic condition of middle-aged and elderly individuals affecting cervical nerve roots and spinal cord function from the neck down.

Key Points

  • Cervical spondylotic myelopathy is an arthritic condition affecting the cervical facet joints and discs producing bony ridging in the central canal and neural foramina, resulting in compressive signs and symptoms of spinal cord and nerve root compression.
  • Presenting features may involve a mix of upper and lower motor neuron dysfunction in the arms and hands, and upper motor neuron dysfunction in the legs.
  • The diagnosis is established by combining clinical findings with the imaging characteristics of bony narrowing of the central and lateral aspects of the cervical spinal canal, as seen on MRI and CT.
  • Treatment is directed at controlling arthritic axial neck pain, and surgical decompression with or without fusion is considered if signs and symptoms of myelopathy are present.