The Natural History and Clinical Presentation of Cervical Spondylotic Myelopathy

Cervical spondylotic myelopathy (CSM) refers to impaired function of the spinal cord caused by degenerative changes of the cervical spine resulting in spinal cord compression. It is the most common disorder in the United States causing dysfunction of the spinal cord. A literature review of the natural history of mild cervical myelopathy is undertaken. Clinical presentation and current concepts of pathophysiology are also discussed. While many patients with mild signs of CSM will stabilize or improve over time with conservative treatment, the clinical course of a specific individual patient cannot be predicted. Asymptomatic patients with cervical stenosis and abnormalities on electrophysiologic studies may be at higher risk for developing myelopathy.

[1]  Sadasivan Kk,et al.  The natural history of cervical spondylotic myelopathy. , 1993 .

[2]  J. Caillé,et al.  Diffusion-weighted MR imaging with apparent diffusion coefficient and apparent diffusion tensor maps in cervical spondylotic myelopathy. , 2003, Radiology.

[3]  Robert C. Cantu,et al.  Rugby Union Injuries to the Cervical Spine and Spinal Cord , 2002, Sports medicine.

[4]  O Vlach,et al.  Spondylotic cervical myelopathy: three aspects of the problem. , 2000, Supplements to Clinical neurophysiology.

[5]  M. Kurosaka,et al.  Prognostic Factors for Deterioration of Patients With Cervical Spondylotic Myelopathy After Nonsurgical Treatment , 2007, Spine.

[6]  B. Tay,et al.  Natural history of cervical myelopathy , 2004 .

[7]  W. R. Brain,et al.  The neurological manifestations of cervical spondylosis. , 1952, Brain : a journal of neurology.

[8]  K Ono,et al.  Motion Analysis of the Cervical Spine in Athetoid Cerebral Palsy: Extension-Flexion Motion , 1990, Spine.

[9]  Hitoshi Takahashi,et al.  Cervical Spondylotic Myelopathy: Clinicopathologic Study on the Progression Pattern and Thin Myelinated Fibers of the Lesions of Seven Patients Examined During Complete Autopsy , 1996 .

[10]  J. Turner,et al.  Natural History and Prognosis of Cervical Spondylosis , 1963, British medical journal.

[11]  H. Akiyama,et al.  [On cervical spondylotic myelopathy]. , 1966, No to shinkei = Brain and nerve.

[12]  H. Pavlov,et al.  The Relationship of Developmental Narrowing of the Cervical Spinal Canal to Reversible and Irreversible Injury of the Cervical Spinal Cord in Football Players. An Epidemiological Study* , 1996, The Journal of bone and joint surgery. American volume.

[13]  J. Albright,et al.  The natural history of cervical spondylotic myelopathy. , 1993, The Yale journal of biology and medicine.

[14]  J. T. Bennett,et al.  Lower Cervical Spondylosis and Myelopathy in Adults with Down's Syndrome , 1988, Spine.

[15]  Tomoyuki Saito,et al.  The Correlation of Diffusion-Weighted Magnetic Resonance Imaging in Cervical Compression Myelopathy With Neurologic and Radiologic Severity , 2008, Spine.

[16]  P H Crandall,et al.  Cervical spondylotic myelopathy. , 1966, Journal of neurosurgery.

[17]  E. Benzel,et al.  Cervical laminectomy and dentate ligament section for cervical spondylotic myelopathy. , 1991, Journal of spinal disorders.

[18]  L. Pollak,et al.  Neurosurgical intervention for cervical disk disease in dystonic cerebral palsy , 1998, Movement disorders : official journal of the Movement Disorder Society.

[19]  L. Dušek,et al.  Predictive factors for mild forms of spondylotic cervical myelopathy treated conservatively or surgically , 2005, European journal of neurology.

[20]  K. Yonenobu,et al.  Canal Diameter, Anteroposterior Compression Ratio, and Spondylotic Myelopathy of the Cervical Spine , 1983, Spine.

[21]  J D Bartleson,et al.  Cervical Spondylotic Myelopathy , 2010, The neurologist.

[22]  K. Tamai,et al.  Association of the Japanese Orthopaedic Association Score With the Oswestry Disability Index, Roland-Morris Disability Questionnaire, and Short-Form 36 , 2003, Spine.

[23]  K. Shichikawa,et al.  Operations for cervical spondylotic myelopathy. A comparison of the results of anterior and posterior procedures. , 1985, The Journal of bone and joint surgery. British volume.

[24]  K. Ono,et al.  Cervical Myelopathy Secondary to Multiple Spondylotic Protrusions: A Clinicopathologic Study , 1977 .

[25]  P. Kaplan.  Cervical spondylitic myelopathy. , 1978, Archives of neurology.

[26]  K. Takeshita,et al.  Conservative treatment for cervical spondylotic myelopathy: achievement and sustainability of a level of "no disability". , 1998, Journal of spinal disorders.

[27]  L. Symon,et al.  The surgical treatment of cervical spondylotic myelopathy , 1967, Neurology.

[28]  M. Hamada,et al.  Etiologic factors of myelopathy. A radiographic evaluation of the aging changes in the cervical spine. , 1987, Clinical orthopaedics and related research.

[29]  Y. Toyama,et al.  Relationships Between Outcomes of Conservative Treatment and Magnetic Resonance Imaging Findings in Patients With Mild Cervical Myelopathy Caused by Soft Disc Herniations , 2001, Spine.

[30]  Jeffrey C. Wang,et al.  Correlation Between a Positive Hoffmann’s Reflex and Cervical Pathology in Asymptomatic Individuals , 2001, Spine.

[31]  John D. Davis,et al.  Outcome of patients treated for cervical myelopathy. A prospective, multicenter study with independent clinical review. , 2000, Spine.

[32]  L. Dušek,et al.  Presymptomatic spondylotic cervical myelopathy: an updated predictive model , 2008, European Spine Journal.

[33]  Keshav R. Rao,et al.  Cervical myelopathy secondary to movement disorders: case report. , 1989, Neurosurgery.

[34]  S. Kawai,et al.  Cervical Spondylotic Myelopathy in the Aged Patient , 1990 .

[35]  H. Larocca,et al.  The Developmental Segmental Sagittal Diameter of the Cervical Spinal Canal in Patients with Cervical Spondylosis , 1983, Spine.

[36]  J M Caillé,et al.  Age-Related Changes in the Cervical Spines of Front-Line Rugby Players , 1999, The American journal of sports medicine.

[37]  Charles H. Brown,et al.  The American Journal of Sports Medicine , 2005 .

[38]  J. Bednařík,et al.  The value of somatosensory and motor evoked potentials in pre-clinical spondylotic cervical cord compression , 1998, European Spine Journal.

[39]  Jeffrey C. Wang,et al.  Cervical spinal canal stenosis: the differences between stenosis at the lower cervical and multiple segment levels , 2011, International Orthopaedics.

[40]  P. K. Robinson,et al.  Cervical myelopathy: a complication of cervical spondylosis. , 1956, Brain : a journal of neurology.

[41]  D. Gore.  Roentgenographic Findings in the Cervical Spine in Asymptomatic Persons: A Ten-Year Follow-up , 2001, Spine.

[42]  W. R. Brain,et al.  Discussion on Rupture of the Intervertebral Disc in the Cervical Region , 1948, Proceedings of the Royal Society of Medicine.

[43]  D. Phillips.  Surgical treatment of myelopathy with cervical spondylosis , 1973, Journal of neurology, neurosurgery, and psychiatry.

[44]  M. Xiangshui,et al.  3 T magnetic resonance diffusion tensor imaging and fibre tracking in cervical myelopathy. , 2010, Clinical radiology.

[45]  K. Ono,et al.  Experimental Spondylosis in the Rabbit Spine Overuse Could Accelerate the Spondylosis , 1992, Spine.

[46]  R. Ueno,et al.  Cervical spondylotic myelopathy in the aged patient. A radiographic evaluation of the aging changes in the cervical spine and etiologic factors of myelopathy. , 1988, Spine.

[47]  L. Dušek,et al.  Approaches to Spondylotic Cervical Myelopathy: Conservative Versus Surgical Results in a 3-year Follow-up Study , 2002, Spine.

[48]  L. Dušek,et al.  Presymptomatic Spondylotic Cervical Cord Compression , 2004, Spine.