Cervical myelopathy: current knowledge on the diagnosis and treatment

Józef Opara1,2

Affiliation and address for correspondence
Aktualn Neurol 2019, 19 (4), p. 174–178
DOI: 10.15557/AN.2019.0024

Cervical myelopathy, also known as cervical spondylotic myelopathy or degenerative cervical myelopathy, is one of the most common causes of disability in the elderly. This disease entity is much more common than it is diagnosed. Degenerative changes leading to critical spinal stenosis are the cause of pressure on the roots and spinal cord in the cervical spine. The first symptoms usually include numbness in the hands and brachial neuralgia; after some time gait disturbances, sphincter dysfunction and impotence appear. Neurological examination shows paresis and atrophy of the muscles of the hands, which may be followed by pyramidal paresis of the lower extremities with neurogenic dysfunction of the bladder. Problems with potency are the reason for the first visit to a doctor for many men. The diagnosis is based on magnetic resonance imaging as well as neurological and neurophysiological examination. There are a number of specific clinimetric scales and tests that facilitate diagnosis and evaluation of cervical myelopathy treatment outcomes. The natural course of the disease, difficult to predict, is usually slow. Some patients require surgical treatment; however; the improvement seen at the beginning disappears over time. This review article presents the current state of knowledge about the diagnosis, course and treatment of cervical myelopathy.

cervical myelopathy, CSM, DCM, diagnosis, treatment, prognosis

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