Cervical spondylotic myelopathy

What it is

Cervical myelopathy is degenerative cervical spine and disc disease with canal stenosis and cord compression. Cervical spondylosis (arthritis) or midline disc protrusion can cause it.

Causes and risk

The epidemiology given is age >55, with degenerative cervical spine and discs, canal stenosis and cord compression.

How it presents

Gait dysfunction is usually first, then extremity weakness and numbness. There are LMN signs in the arms, muscle atrophy and hyporeflexia, and UMN signs in the legs, Babinski and hyperreflexia, with reduced proprioception, vibration and pain sensation. The neck pain and stiffness can be mild. The patient can have both lower motor neuron signs such as atrophy, reflex loss and even fasciculations in the arms, and upper motor neuron signs such as hyperreflexia and clonus, from cord compression, in the legs, so it can mimic amyotrophic lateral sclerosis.