20 - Cervical myelopathy

Abstract

Myelopathy is used to define any neurological dysfunction associated with a pathology of the spinal cord. Although diverse factors can produce spinal cord injury, degenerative cervical myelopathy represents the most common etiology. Degenerative myelopathy may result from spondylosis, disc herniation, or facet arthropathy, as well as ligamentous hypertrophy, calcification, or ossification. Degenerative cervical myelopathy accounts for 54% of all the nontraumatic spinal cord injuries in the United States. This condition is usually diagnosed during the fifth decade of life and most commonly affects the C5-C6 level. Initial symptoms frequently include gait disturbances and fine motor deficits. The challenging task in evaluating patients with myelopathy is correlating the severity of symptomatology with the degree of radiographic compression. Although no consensus exists regarding the ideal approach and strategy, surgical decompression is associated with significant and sustainable improvements in neurological outcomes, functional status, and health-related quality of life.