Cervical Spondylotic Myelopathy

Cervical spondylotic myelopathy (CSM) is spinal cord compression by disc herniation/osteophytes/ligamentum flavum hypertrophy. Clinical: hand clumsiness, gait instability, weakness, hyperreflexia, Babinski, Hoffmann, Lhermitte, sensory changes, urinary urgency. Diagnosis: cervical MRI (gold standard), X-ray, EMG/NCS. Treatment: conservative: PT (isometric, avoid flexion), NSAIDs, soft collar, activity modification; surgical: anterior cervical discectomy and fusion (ACDF), posterior laminectomy/laminoplasty, for progressive myelopathy, severe deficit, or failed conservative; manage comorbidities; follow-up orthopedics/neurosurgery/neurology.

Common Symptoms

Hand clumsiness; gait instability; weakness; hyperreflexia; urinary urgency

Causes and Pathogenesis

Disc/osteophyte/ligament compression of cervical cord causes myelopathy.

Treatment

Conservative: PT/NSAIDs/collar; surgical: ACDF/laminectomy

Preventive Measures

Neck posture; avoid flexion trauma; early diagnosis.

Department to Visit

It is recommended to visit the Orthopedics/Neurosurgery/Neurology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.