With cervical spondylotic myelopathy, patients have a compression of the spinal cord in the cervical region, which is in the neck. This spinal cord disorder is common among adults who are older than age 50, though symptoms may appear in younger patients who have had past neck injuries. The spinal cord compression impairs the blood flow in the spine, affecting its normal functioning.
Cervical spondylotic myelopathy causes several types of symptoms. Emory Healthcare noted that commonly, the first symptom of the disorder is gait spasticity — the patient’s gait is jerky and hesitant. Patients may have trouble walking.
William F. Young, M.D., of Temple University Hospital, added that in the early stages of cervical spondylotic myelopathy, neck stiffness is common; this is due to advanced cervical spondylosis. This disorder can cause sensation changes. For example, patients may have numbness in their upper extremities. Sensation changes can also occur in the lower extremities.
Patients may have changes in their motor functions, such as losing control of their fine motor skills in their hands. As a result, patients can have trouble using their hands, which may include trouble writing, feeding themselves, or buttoning a shirt.
Emory Healthcare noted that motor weakness can occur in the extremities. Weakness may cause patients to drop items or have trouble picking up objects. Other symptoms of cervical spondylotic myelopathy include a loss of bowel or bladder control, arm pain and neck pain.
The symptoms of cervical spondylotic myelopathy tend to progress steadily and slowly over several years. But for some patients, their symptoms do not follow this progression. The American Academy of Orthopaedic Surgeons stated that between 5 to 20 percent of patients with cervical spondylotic myelopathy have symptoms that progress rapidly.
To diagnose cervical spondylotic myelopathy, the physician will perform a physical examination and order scans to examine the spinal cord. With the physical examination, the physician will check the patient’s sensory abilities, her strength levels and her reflexes. For example, the physician will see if the patient has hyper-reflexia, which is an overactive reflex.
Imaging will help the physician confirm a diagnosis of cervical spondylotic myelopathy. Options include x-rays, magnetic resonance imaging and computed tomography. Young noted that MRIs are the preferred choice when performing the initial screening, with a CT providing complementary information. For example, an MRI can show the narrowing of the spinal canal, while a CT can show more detail of bone spur formations.
References
Young, W.F. “Cervical Spondylotic Myelopathy: A Common Cause of Spinal Cord Dysfunction in Older Persons.” American Academy of Family Physicians. 1 September 2000. Web. 22 December 2011
http://www.neuroanatomy.wisc.edu/selflearn/CSM.htm
American Academy of Family Physicians. Cervical Spondylotic Myelopathy. Web. 22 December 2011
http://familydoctor.org/familydoctor/en/diseases-conditions/cervical-spondylotic-myelopathy.printerview.all.html
Emory Healthcare. Cervical Spondylotic Myelopathy. Web. 22 December 2011
http://www.emoryhealthcare.org/spine/medical-conditions/cervical-spondylotic-myelopathy.html
American Academy of Orthopaedic Surgeons. Cervical Spondylotic Myelopathy. Web. 22 December 2011
http://orthoinfo.aaos.org/topic.cfm?topic=A00541
Reviewed December 22, 2011
by Michele Blacksberg RN
Edited by Jody Smith