Cervical spondylotic myelopathy

Cervical spondylotic myelopathy, otherwise known as CSM, is a condition where the function of the spinal cord is impaired after degenerative changes in the facet joints and discs during adult life. Cervical spondylotic myelopathy is the most common cause of spinal cord dysfunction in the United States, and is a mojor contributor to spinal cord dysfunction in countries around the world. The onset of cervical spondylotic myelopathy can be affected by the degree of narrowing in the congenital spinal canal and is most often found in patients over 50 years in age.

Spinal cord compression is caused by a process called cervical spondylosis. Unfortunately cervical spondylosis is not fully understood within the medical community and most probably has a number of causal factors. Thickening of the ligaments surrounding the spinal canal paralleling the loss in disc height, changes to the intervertebral discs manifest in bone spurs at the margins of the vertebrae, arthritis in the neck and general wear and tear can all point to cervical spondylotic myelopathy.

Such changes to the spinal cord and cervical spine can cause the spinal canal to narrow, which then causes the posterior longitudinal ligament to thicken and the formation of bone spurs that compress the spinal cord. As a result of this process a chronic compression of the spinal cord can occur, which may lead to impaired blood flow and ultimately neurological damage.

While more than 50% of patients diagnosed with cervical spondylotic myelopathy do not complain of pain, others report a sharp stabbing pain, prolonged dull pains through the arm to fingertips with 'pins and needles' in the fingertips, as well as a burning sensation. Patients with cervical spondylotic myelopathy may also exhibit problems with daily tasks such as dressing themselves and performing household work.

In prolonged cases of patients with cervical spondylotic myelopathy muscle waste and a loss of sensation may occur over time. Coordination can be affected as balance and sensation at the extremities are impaired. As the condition progresses, both legs may begin to weaken and become increasingly spastic. The patient's control over bowel and sphincter functions may also be altered as the condition progresses.

Cervical spondylotic myelopathy symptoms

  • Poor balance when walking
  • Weakness when walking
  • A numbness in the legs
  • Impaired use of arms, hands and fingers
  • Stiff and painful neck