Cervical myelopathy (original) (raw)
Related papers
Cervical spondylotic myelopathy: pathophysiology, clinical presentation, and treatment
HSS journal : the musculoskeletal journal of Hospital for Special Surgery, 2011
Age-related changes in the spinal column result in a degenerative cascade known as spondylosis. Genetic, environmental, and occupational influences may play a role. These spondylotic changes may result in direct compressive and ischemic dysfunction of the spinal cord known as cervical spondylotic myelopathy (CSM). Both static and dynamic factors contribute to the pathogenesis. CSM may present as subclinical stenosis or may follow a more pernicious and progressive course. Most reports of the natural history of CSM involve periods of quiescent disease with intermittent episodes of neurologic decline. If conservative treatment is chosen for mild CSM, close clinical and radiographic follow-up should be undertaken in addition to precautions for trauma-related neurologic sequelae. Operative treatment remains the standard of care for moderate to severe CSM and is most effective in preventing the progression of disease. Anterior surgery is often beneficial in patients with stenotic disease ...
Degenerative Cervical Myelopathy: Clinical Presentation, Assessment, and Natural History
Journal of Clinical Medicine
Degenerative cervical myelopathy (DCM) is a leading cause of spinal cord injury and a major contributor to morbidity resulting from narrowing of the spinal canal due to osteoarthritic changes. This narrowing produces chronic spinal cord compression and neurologic disability with a variety of symptoms ranging from mild numbness in the upper extremities to quadriparesis and incontinence. Clinicians from all specialties should be familiar with the early signs and symptoms of this prevalent condition to prevent gradual neurologic compromise through surgical consultation, where appropriate. The purpose of this review is to familiarize medical practitioners with the pathophysiology, common presentations, diagnosis, and management (conservative and surgical) for DCM to develop informed discussions with patients and recognize those in need of early surgical referral to prevent severe neurologic deterioration.
Degenerative cervical myelopathy: Diagnosis and management in primary care
Canadian family physician Medecin de famille canadien, 2019
OBJECTIVE To raise awareness about degenerative cervical myelopathy (DCM) and to help family physicians identify, diagnose, and manage DCM more effectively. SOURCES OF INFORMATION A PubMed search was conducted for articles published between 1970 and October 2017, using the terms cervical myelopathy and degenerative spinal cord injury with family medicine or primary care. MAIN MESSAGE Owing to limited knowledge of DCM in primary care, along with the large variability of the disease, the diagnosis of DCM is often missed or delayed. The natural course of DCM presents as a stepwise decline, with symptoms ranging from muscle weakness to complete paralysis. All individuals with signs and symptoms should be referred to a spine surgeon for consideration of surgery; those with mild DCM might be offered conservative treatment but should receive a surgical evaluation and opinion nonetheless. Asymptomatic patients with evidence of cord compression on magnetic resonance imaging might need to be ...
Degenerative Cervical Myelopathy : Introduction , Rationale , and Scope
2019
Degenerative cervical myelopathy (DCM) is a progressive spine disease and the most common cause of spinal cord dysfunction in adults worldwide. Patients with DCM may present with common signs and symptoms of neurological dysfunction, such as paresthesia, abnormal gait, decreased hand dexterity, hyperreflexia, increased tone, and sensory dysfunction. Clinicians across several specialties encounter patients with DCM, including primary care physicians, rehabilitation specialists, therapists, rheumatologists, neurologists, and spinal surgeons. Currently, there are no guidelines that outline how to best manage patients with mild (defined as a modified Japanese Orthopedic Association (mJOA) score of 15-17), moderate (mJOA 1⁄4 12-14), or severe (mJOA 11) myelopathy, or nonmyelopathic patients with evidence of cord compression. This guideline provides evidencebased recommendations to specify appropriate treatment strategies for these populations. The intent of our recommendations is to (1) ...
Cervical Spondylosis Myelopathy- a Review
Era's Journal of Medical Research, 2020
Study Design: Review. Objectives: Cervical spondylotic myelopathy (CSM) is a significant reason of disability, especially in old-aged patients. Mindfulness and comprehension of CSM is basic to encourage early analysis and the executives. This review article delivers CSM concerning its the study of disease transmission, pathophysiology, clinical indications, imaging, treatment draws near. Methods: The authors played out a broad survey of the companion audited writing tending to the previously mentioned goals. Results: The clinical introduction and normal history of CSM is variable, switching back and forth among quiet and slippery to stepwise decay or quick neurological crumbling. For gentle CSM, preservationist choices could be utilized with cautious perception. Notwithstanding, careful intercession has demonstrated to be better for moderate than extreme CSM. The achievement of employable or traditionalist administration of CSM is multifactorial and top notch contemplates are inadeq...
Degenerative Cervical Myelopathy: A Review of Current Concepts
Coluna/Columna, 2020
Herbert von Luschka, a German anatomist, was the first to describe the developmental changes in the anatomical structures of the cervical spine. Degenerative cervical myelopathy (DCM) represents a collection of pathological entities that cause compression of the cervical spinal cord, resulting in a clinical syndrome typified by spasticity, hyperreflexia, pathologic reflexes, finger/hand clumsiness, gait disturbance and sphincter dysfunction. In the cervical spine, certain patients are more likely to have myelopathy due to a congenitally narrowed cervical spine canal. Degenerative changes are more common at C5 and C6 or C6 and C7 due to the increased motion at these levels. Additional contributors to canal narrowing are infolding of the ligamentum flavum, olisthesis, osteophytes, and facet hypertrophy. Myelopathy will develop in approximately 100% of patients with canal stenosis greater than 60% (less than 6 mm sagittal disc cord space). Classically it has an insidious onset, progres...
Cervical spondylotic myelopathy: what the neurologist should know
Cervical spondylotic myelopathy is a well-known cause of disability among older people. A significant amount of these patients is asymptomatic. Once the symptoms start, the worsening may follow a progressive manner. We should suspect of spondylotic myelopathy in any individual over 55 years presenting progressive changes in gait or losing fine motor control of the upper limbs. Despite its frequent prevalence, this condition is still neglected and many times confused with other supratentorial lesions regarding diagnostic. Here we address some of most important aspects of this disease , calling attention to pathophysiology, the natural history, presentation, differential diagnosis , clinical assessment, and treatment.
The patient was an 80 year old woman admitted to the hospital in an inpatient setting for pain control and further evaluation after a fall at home which resulted in severe low back pain and difficulty walking. Physical therapy was consulted to assess gait and transfer capabilities. At the time of initial physical therapy examination, the patient demonstrated poor bed mobility and transfer capabilities. She also demonstrated poor to fair upper or lower extremity strength with more pronounced weakness on the right. General hyperreflexia was noted (hyperactive bilateral deep tendon reflexes, positive bilateral Hoffman reflex, bilateral Babinski sign). A computed tomography scan of the head and magnetic resonance imaging of the cervical spine were ordered to assess for a cerebrovascular accident and cervical myelopathy, respectively. The cervical magnetic resonance imaging confirmed the diagnosis of cervical spondylotic myelopathy (Figure 1). The patient subsequently underwent successful surgical decompression laminoplasty from C3 to C6.