Cervical myelopathy is a clinical syndrome characterized by clumsiness in hands, gait imbalance, and weakness. It is most commonly caused by compression of the spinal cord however other disease processes can result in similar symptoms
The most common cause of cervical myelopathy is degenerative cervical spondylosis (CSM). In this condition, compression is usually caused by anterior degenerative changes (osteophytes, discosteophyte complex). Degenerative spondylolithesis may contribute to spinal canal narrowing. Some individuals have underlying congenital stenosis. Symptoms usually begin when congenital narrowing is combined with spondylotic degenerative changes but large disc herniations can also result in enough spinal cord compression to cause myelopathy. Other more rare causes include
It is important to remember that patients with cervical stenosis are at increased risk for lumbar stenosis.
Cervical myelopathy tends to be slowly progressive and rarely improves with nonoperative modalities. Progression characterized by steplike deterioration with periods of stable symptoms.
Early recognition and surgical treatment prior to spinal cord damage is critical for good clinical outcomes.