cervical myelopathy

Etiology

• disc herniation
• hypertrophy of the ligamentum flavus
• ossification of the longitudinal ligament
• spinal cord neoplasm
• cervical spondylosis
• congenital anomaly

Clinical manifestations

• patients present with signs & symptoms of cervical spinal cord dysfunction with or without cervical radiculopathy
• neck pain, shoulder pain &/or pain in upper limbs may occur
• loss of manual dexterity
• gait & balance disturbances
• increase tone & heaviness in lower extremities
• Romberg's sign, Babinski's sign
• Lhermitte sign may be present (electric shock sensation with neck flexion)
• sensory loss in the hands or feet
• arm or hand weakness
• fecal or urinary frequency, urinary urgency, or urinary hesitancy
• upper-motor-neuron signs

Radiology

• magnetic resonance imaging (MRI) of the cervical spine

Management

• surgical decompression improves neurologic function in some patients & prevents worsening in others
  • age is an independent predictor of surgical outcome
  • adults > 65 years of age do not have as much improvement in functional status after surgery as younger patients, but report similar quality-of-life improvements

More general terms

• spinal cord disease

More specific terms

• cervical spinal stenosis
• cervical spondylotic myelopathy