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In the lumbar spine it is commonly used to treat spinal claudication caused by spinal stenosis, and is considered the most effective treatment for this condition based on current evidence. [3] In the cervical and thoracic spine it is used to treat myelopathy caused by compression of the spinal cord itself.
Cervical Spondylotic Myelopathy (CSM) is a disorder characterised by the age-related deterioration of the cervical spinal cord. [1] Referred to be a range of different but related terms, a global consensus process selected Degenerative Cervical Myelopathy as the new overarching disease term . [ 2 ]
The most common form of myelopathy in humans, cervical spondylotic myelopathy (CSM), [2] [3] also called degenerative cervical myelopathy, [4] results from narrowing of the spinal canal (spinal stenosis) ultimately causing compression of the spinal cord. [5] When due to trauma, myelopathy is known as (acute) spinal cord injury.
Lumbar stenosis is the most common, followed by cervical stenosis. [2] Diagnosis is generally based on symptoms and medical imaging. [4] Treatment may involve medications, bracing, or surgery. [6] Medications may include NSAIDs, acetaminophen, anticonvulsants (gabapentinoids) or steroid injections.
Postoperative radiation is delivered within 2–3 weeks of surgical decompression. Emergency radiation therapy (usually 20 grays in 5 fractions, 30 grays in 10 fractions or 8 grays in 1 fraction) is the mainstay of treatment for malignant spinal cord compression. It is very effective as pain control and local disease control.
Cervical spinal stenosis is one of the most common forms of spinal stenosis, along with lumbar spinal stenosis (which occurs at the level of the lower back instead of the neck). Thoracic spinal stenosis, at the level of the mid-back, is much less common. [2] Cervical spinal stenosis can be far more dangerous by compressing the spinal cord.
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