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OVERVIEW

What is cervical spondylotic myelopathy?

Cervical spondylotic myelopathy (CSM) is a compression of the spinal cord in the neck. (When healthcare providers say the spinal cord is “compressed,” they mean it is being pressed and squeezed.) CSM often affects older adults, but affects men at an earlier age than women. In people who have CSM, changes in the bones, disks and ligaments of the spine cause pressure on the spinal cord. Sometimes bony growths called bone spurs add pressure to the spine. Some changes are because of normal aging. Some changes are caused by arthritis of the spine. CSM is the most common spinal cord problem in people 55 years of age or older in Canada.

SYMPTOMS

What are the symptoms of CSM?

Symptoms of CSM may develop slowly. Some symptoms of CSM include:

• Neck stiffness
• Arm pain
• Numbness in the hands and weakness of the arms and legs
• Stiff legs
• Difficulty using your hands or walking steadily
• Loss of bladder or bowel control

DIAGNOSIS & TESTS

How is CSM diagnosed?

Your healthcare provider will do a physical exam to see if you have CSM. They will look for changes in your strength, reflexes and ability to feel. Magnetic resonance imaging (MRI) is a way of taking pictures of your spine and can help confirm you have spinal cord compression in your neck. The MRI can also show other problems such as tumors that cause symptoms similar to CSM. If your healthcare provider is not sure that you have CSM, they can do other tests. Your healthcare provider may also want you to see a neurologist.

TREATMENT

How is CSM treated?

If CSM is not treated, it will usually stay the same or get worse. There’s no way to predict whether it will get worse. Your healthcare provider will talk with you about the pros and cons of the treatment options. Mild cases of CSM can be treated with neck braces or neck traction, and physical therapy, but it’s not clear whether these treatments help in the long run. Surgery to reduce the compression of the spinal cord may help some people, but it doesn’t help everyone. Medicines can relieve pain caused by CSM, but they don’t help other symptoms such as weakness or numbness.

QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER

• Can cervical spondylotic myelopathy be a sign of another condition?
• What can I do to prevent the condition from getting worse?
• What can I do to ease the symptoms of cervical spondylotic myelopathy?
• What caused this condition?
• What types of medicines are used to treat cervical spondylotic myelopathy. Are there side effects?
• Can surgery help cervical spondylotic myelopathy?

Sources

Cervical Spondylotic Myelopathy: A Common Cause of Spinal Cord Dysfunction in Older Persons by WF Young (09/01/00, http://www.aafp.org/afp/20000901/1064.html)