Cervical myelopathy

Cervical myelopathy is a progressive spinal cord disorder caused by compression of the spinal cord in the cervical (neck) region. It is most commonly due to cervical spondylosis (age-related degeneration), disc herniation, ossification of the posterior longitudinal ligament (OPLL), or trauma. Patients typically present with neck pain, clumsiness of hands, difficulty with fine motor tasks (e.g., buttoning shirts), gait disturbances, weakness, numbness, and bowel/bladder dysfunction in severe cases. Diagnosis is confirmed with MRI (gold standard), which shows spinal cord compression, and X-rays/CT scans to assess bony changes. Treatment depends on severity; mild cases may be managed conservatively with physiotherapy, cervical collars, and medications, while moderate to severe cases require surgical decompression (e.g., laminectomy, laminoplasty, or anterior cervical discectomy and fusion) to prevent neurological deterioration.

  • Causes: Cervical spondylosis, disc herniation, OPLL, trauma, tumors.

  • Symptoms: Neck pain, clumsy hands, difficulty walking, limb weakness, numbness, bladder/bowel dysfunction.

  • Diagnosis: MRI (gold standard), X-ray, CT scan, electromyography (EMG) for nerve assessment.

  • Conservative: Physiotherapy, pain management, cervical collar (for mild cases).

  • Surgical: Laminectomy, laminoplasty, anterior cervical discectomy and fusion (ACDF) for severe cases.

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