Conditions & Treatments
Cervical spondylotic myelopathy (CSM) refers to impaired function of the spinal cord caused by degenerative changes of the discs and facet joints acquired in adult life. This is the most common disorder causing dysfunction of the spinal cord in the United States. Most patients with this condition are over 50 years of age, but the age of onset is variable, depending on the degree of congenital spinal canal narrowing.
Cervical Spondylotic Myelopathy Causes
The process that leads to spinal cord compression is a result of cervical "arthritis" (also called cervical spondylosis). Changes in the cervical spine produce narrowing of the spinal canal itself, leading to thickening of the posterior longitudinal ligament and bone spur (osteophyte) formation compressing the spinal cord, most commonly at the C4-C7 levels. The end result is chronic compression of the spinal cord and nerve roots leading to impaired blood flow and neurological deficit and resulting in damage within the spinal cord itself.
Cervical Spondylotic Myelopathy Symptoms
Cervical spondylotic myelopathy causes a variety of signs and symptoms. The first sign is commonly gait spasticity, followed by upper extremity numbness and loss of fine motor control in the hands.
Other symptoms of cervical spondylotic myelopathy include:
- Pain in the neck, subscapular area, or shoulder
- Numbness or paresthesia in the upper extremities
- Sensory changes in the lower extremities
- Motor weakness in the extremities
- Gait difficulties ("spastic gait," hesitant and jerky)
- Myelopathic or "upper motor neuron" findings such as spasticity, hyperreflexia, clonus, Babinski, and Hoffman signs, and bowel and bladder dysfunction
- "Lower motor neuron" findings such as upper extremity hyporeflexia and atrophy
Who is a typical cervical spondylotic myelopathy patient?
Most cervical spondylotic myelopathy patients are over 50 years old.
Diagnosing Cervical Spondylotic Myelopathy
The diagnosis of cervical myelopathy depends on the patient's history and the physical findings described above. It may then be confirmed by radiologic imaging, such as an MRI scan of the cervical spine demonstrating overt spinal cord and nerve root compression. A cervical CT myelogram may aid in determination of the anatomy associated with nerve root and spinal cord compression.
Surgical Treatment of Cervical Spondylotic Myelopathy
Some of the surgical procedures used to treat cervical spondylotic myelopathy at Emory are:
NewsView all News
Emory Healthcare news from the Emory News Center
Emory tennis medicine team plays key role in World Congress of Tennis Medicine
December 02, 2016
Emory Healthcare imaging locations named Lung Cancer Screening Centers by American College of RadiologyHeadline Link Title
December 01, 2016
Emory Johns Creek Hospital's Holiday Workshop to feature choral performances, crafts
November 29, 2016
Emory Saint Joseph's nurses recognized during Evening of Magnetism
November 29, 2016
Emory cancer researcher named 2016 AAAS Fellow
November 17, 2016
Pilot program uses physicians in Australia for overnight Atlanta eICU monitoring
November 16, 2016
Torres to hold Glenn Family Chair in Breast Cancer Research at Winship
November 16, 2016
Emory Johns Creek Hospital partners with community pharmacy to improve transition of care for patients
November 14, 2016
Emory nurse receives National Magnet Nurse of the Year Award
November 11, 2016
Speeding sepsis response: Stopping it in time
November 02, 2016