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Cervical Spondylotic Myelopathy (CSM) is a disorder characterised by the age-related deterioration of the cervical spinal cord. [1] Referred to be a range of different but related terms, a global consensus process selected Degenerative Cervical Myelopathy as the new overarching disease term . [ 2 ]
In older patients, CCS most often occurs after acute hyperextension injury in an individual with long-standing cervical spondylosis.A slow, chronic cause in this age group is when the cord gets caught and squeezed between a posterior intervertebral disc herniation against the anterior cord and/or with posterior pressure on the cord from hypertrophy of the ligamentum flavum (Lhermitte's sign ...
The most common form of myelopathy in humans, cervical spondylotic myelopathy (CSM), [2] [3] also called degenerative cervical myelopathy, [4] results from narrowing of the spinal canal (spinal stenosis) ultimately causing compression of the spinal cord. [5] When due to trauma, myelopathy is known as (acute) spinal cord injury.
In cervical spondylosis, a patient may be presented with dull neck pain with neck stiffness in the initial stages of the disease. As the disease progresses, symptoms related to radiculopathy (due to compression of exiting spinal nerve by narrowed intervertebral foramen) or myelopathy (due to compression on the spinal cord) can occur. [2]
Spondylolysis is a bony defect or fracture within the pars interarticularis of the vertebral arch in the spinal column. The vast majority of spondylolysis occur in the lumbar vertebrae, however it can also be seen in cervical vertebrae. [2]
Spinal abnormalities such as flattening of the lumbar lordosis, exaggeration of the thoracic kyphosis, and hyperextension of the cervical spine lead to limited spinal motion. Hip and shoulder arthritis can occur in some people with ankylosing spondylitis , usually early in the course of the illness.
Occipito-cervical junction This disorder may result from rheumatoid arthritis, causing the hypermobility of the connection between the neck and head, resulting in paralysis or pain. [ 6 ] Cerebrovascular disease Cerebrovascular disease is a type of cervical spine disorder that can cause tetraplegia .
In central spinal cord syndrome, impairment of motor function in the upper body is considerably more severe than that of lower body, which is related to hyperextension of corticospinal tracts and spinocerebellar tract in cervical spinal cord, accompanied by dysfunction in urinary bladder and sensational loss at a varying degree. [5] [14]