Cervical myelopathy - clinical fact sheet and MCQ

Overview

Cervical myelopathy is a progressive neurological condition arising from compression of the spinal cord in the cervical spine. The most prevalent form, degenerative cervical myelopathy (DCM), results from age-related changes such as intervertebral disc degeneration, ligamentous hypertrophy or ossification, osteophyte formation, and congenital or acquired spinal canal stenosis. It is the leading cause of spinal cord dysfunction in adults worldwide. Though the onset is often insidious, the clinical course varies; some individuals experience a gradual stepwise decline, while others remain stable for prolonged periods. However, even patients who appear stable may experience sudden deterioration. Therefore, ongoing monitoring is essential.

The condition most commonly presents in men, and age of onset is typically late 50s to early 60s. It predominantly affects the C5-C6 level of the spinal cord, followed by C6-C7 and C4-C5. The pathophysiology includes both static compression and dynamic stress during cervical movement, which contribute to vascular insufficiency, inflammation, and neural tissue injury.

Diagnosis of cervical myelopathy