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Myelopathy Cervical spondylotic myelopathy (CSM) is caused by compression of the spinal cord in the upper spine, or cervical stenosis. Bony spurs formed by long-standing arthritis grow into the canal and compress or place pressure on the cord. Symptoms of myelopathy include neck pain, problems with balance, numbness in the hands and fingertips, and difficulty with fine movements like buttoning a shirt. Patients can also display exaggerated reflexes. Conditions that can result in myelopathy are multiple sclerosis, amyotrophic lateral sclerosis, and spinal cord disorder. However, cervical spondylotic myelopathy is the most common cause of spinal cord dysfunction in the elderly. The diagnosis of CSM is usually confirmed by magnetic resonance imaging which shows narrowing of the spinal canal. The most common procedure performed to relieve compression or pressure on the spinal cord or nerve roots is anterior cervical decompression. Since removal of bone during a decompression may disrupt continuity and increase instability of that area of the spine, a fusion is also performed to provide structural stability.  |
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