Cervical and Thoracic Spondylotic Myelopathies

Abstract Spondylotic myelopathies are among the most common disorders of the spine, yet the clinical and treatment approach is far from standardized. This article discusses our current understanding of the epidemiology, pathophysiology, clinical assessment, natural history, and treatment options in degenerative myelopathies of the cervical and thoracic spine. We additionally review diagnostic modalities including imaging modalities of the spine and neurophysiological tools such as electromyography/nerve conduction studies, somatosensory-evoked potentials, and motor-evoked potentials. Assessment instruments that can be used for the assessment of myelopathies are reviewed, including the Japanese Orthopedic Association (JOA) score, modified-JOA scale, Nurick scale, nine-hole peg test, and 30-m walking test. We also review common disorders that mimic spondylotic myelopathies, as well as helpful diagnostic clues in differentiating spondylotic and nonspondylotic myelopathies.

[1]  Y. Liu,et al.  Correlation between diffusion tensor imaging parameters and clinical assessments in patients with cervical spondylotic myelopathy with and without high signal intensity , 2017, Spinal Cord.

[2]  Allan R. Martin,et al.  Nonoperative Versus Operative Management for the Treatment Degenerative Cervical Myelopathy: An Updated Systematic Review , 2017, Global spine journal.

[3]  K. Fountas,et al.  The Role of Gait Analysis in the Evaluation of Patients with Cervical Myelopathy: A Literature Review Study. , 2017, World neurosurgery.

[4]  Zhongjun Liu,et al.  Does Dynamic Supine Magnetic Resonance Imaging Improve the Diagnostic Accuracy of Cervical Spondylotic Myelopathy? A Review of the Current Evidence. , 2017, World neurosurgery.

[5]  Jun S. Kim,et al.  State of the Art in Degenerative Cervical Myelopathy: An Update on Current Clinical Evidence , 2017, Neurosurgery.

[6]  Parker E. Bohm,et al.  Psychometric properties of the 30-m walking test in patients with degenerative cervical myelopathy: results from two prospective multicenter cohort studies. , 2017, The spine journal : official journal of the North American Spine Society.

[7]  M. Fehlings,et al.  Surgery for degenerative cervical myelopathy: a patient-centered quality of life and health economic evaluation. , 2016, The spine journal : official journal of the North American Spine Society.

[8]  Alpesh A. Patel,et al.  The Triangle Model of Congenital Cervical Stenosis , 2016, Spine.

[9]  Sakae Tanaka,et al.  Comparison of the Japanese Orthopaedic Association (JOA) Score and Modified JOA (mJOA) Score for the Assessment of Cervical Myelopathy: A Multicenter Observational Study , 2015, PloS one.

[10]  M. Kiernan,et al.  Patterns of clinical and electrodiagnostic abnormalities in early amyotrophic lateral sclerosis , 2014, Muscle & nerve.

[11]  M. Fehlings,et al.  A clinical prediction model to assess surgical outcome in patients with cervical spondylotic myelopathy: internal and external validations using the prospective multicenter AOSpine North American and international datasets of 743 patients. , 2014, The spine journal : official journal of the North American Spine Society.

[12]  B. Meyer,et al.  Treatment considerations of cervical spondylotic myelopathy. , 2014, Neurology. Clinical practice.

[13]  R. Marsh,et al.  Specific pattern of gadolinium enhancement in spondylotic myelopathy , 2014, Annals of neurology.

[14]  X. Liu,et al.  Clinical Features of Thoracic Spinal Stenosis-associated Myelopathy: A Retrospective Analysis of 427 Cases , 2014, Clinical spine surgery.

[15]  G. Ghobrial,et al.  Cervical spondylotic myelopathy in the young adult: A review of the literature and clinical diagnostic criteria in an uncommon demographic , 2014, Clinical Neurology and Neurosurgery.

[16]  M. Fehlings,et al.  Anterior Versus Posterior Surgical Approaches to Treat Cervical Spondylotic Myelopathy: Outcomes of the Prospective Multicenter AOSpine North America CSM Study in 264 Patients , 2013, Spine.

[17]  M. Fehlings,et al.  Ancillary Outcome Measures for Assessment of Individuals With Cervical Spondylotic Myelopathy , 2013, Spine.

[18]  M. Fehlings,et al.  Pathophysiology and Natural History of Cervical Spondylotic Myelopathy , 2013, Spine.

[19]  J. Bartleson,et al.  Cervical spondylotic myelopathy. , 2013, Neurologic clinics.

[20]  E. Logigian,et al.  Unexpected neuroimaging abnormalities in patients with apparent C8 radiculopathy: Broadening the clinical spectrum , 2012, Muscle & nerve.

[21]  Yih-Ru Wu,et al.  Electrophysiological features of hirayama disease , 2011, Muscle & nerve.

[22]  L. Dušek,et al.  Cervical spondylotic myelopathy: conservative versus surgical treatment after 10 years , 2011, European Spine Journal.

[23]  M. Smyth,et al.  Idiopathic syrinx in the pediatric population: a combined center experience. , 2010, Journal of neurosurgery. Pediatrics.

[24]  Kozo Nakamura,et al.  Correlation between pyramidal signs and the severity of cervical myelopathy , 2010, European Spine Journal.

[25]  J. Bartleson,et al.  Spine Disorders: Medical and Surgical Management , 2009 .

[26]  T. Krings,et al.  Spinal Dural Arteriovenous Fistulas , 2009, American Journal of Neuroradiology.

[27]  S. Olindo,et al.  Quantitative assessment of hand disability by the Nine-Hole-Peg test (9-HPT) in cervical spondylotic myelopathy , 2008, Journal of Neurology, Neurosurgery, and Psychiatry.

[28]  J. Glass,et al.  Clinical, electrophysiologic, and pathologic evidence for sensory abnormalities in ALS , 2007, Neurology.

[29]  H. Vitzthum,et al.  Analysis of five specific scores for cervical spondylogenic myelopathy , 2007, European Spine Journal.

[30]  H. Ozawa,et al.  Thoracic myelopathy in Japan: epidemiological retrospective study in Miyagi Prefecture during 15 years. , 2006, The Tohoku journal of experimental medicine.

[31]  M. Kurosaka,et al.  Proprioceptive Recovery of Patients With Cervical Myelopathy After Surgical Decompression , 2005, Spine.

[32]  J. Pouget,et al.  Lewis–Sumner syndrome and multifocal motor neuropathy , 2005, Muscle & nerve.

[33]  J. Dvořák,et al.  Cervical myelopathy: clinical and neurophysiological evaluation , 2003, European Spine Journal.

[34]  Kimatha Oxford Grice,et al.  Adult norms for a commercially available Nine Hole Peg Test for finger dexterity. , 2003, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[35]  Anoushka Singh,et al.  Quantitative assessment of cervical spondylotic my elopathy by a simple walking test , 1999, The Lancet.

[36]  M C Speer,et al.  Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. , 1999, Neurosurgery.

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

[38]  K. Kurisu,et al.  Epidemiology and Overview of the Clinical Spectrum of Degenerative Cervical Myelopathy. , 2018, Neurosurgery clinics of North America.

[39]  M. Fehlings,et al.  The modified Japanese Orthopaedic Association scale: establishing criteria for mild, moderate and severe impairment in patients with degenerative cervical myelopathy , 2016, European Spine Journal.

[40]  Toshihiko Sakakibara,et al.  Overactive bladder in cervical spondylotic myelopathy , 2014, Journal of Orthopaedic Science.