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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.
Although often considered a classic finding in multiple sclerosis, it can be caused by a number of conditions, including transverse myelitis, Behçet disease, [4] osteogenesis imperfecta, [5] trauma, radiation myelopathy, [6] vitamin B12 deficiency (subacute combined degeneration), compression of the spinal cord in the neck from any cause such ...
In cervical spondylosis, a patient may be presented with dull neck pain with neck stiffness in the initial stages of the disease. As the disease progresses, symptoms related to radiculopathy (due to compression of exiting spinal nerve by narrowed intervertebral foramen) or myelopathy (due to compression on the spinal cord) can occur. [2]
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.
Myelomalacia is a pathological term referring to the softening of the spinal cord. [1] Possible causes of myelomalacia include cervical myelopathy, hemorrhagic infarction, or acute injury, such as that caused by intervertebral disc extrusion.
The impact of craniocervical instability can range from minor symptoms to severe disability in which patients are bed-bound. The constellation of symptoms caused by craniocervical instability is known as "cervico-medullary syndrome" [4] and includes: [5] [6] [7]
Individuals with severe myelopathy will need a fiberoptic intubation scope to prevent the risk of extension of the cervical spine during the intubation process. The patient is then placed on a Jackson table with a Mayfield tong. The chest, iliac crests, arms, and knees all have gel padding and mats placed for support. The patient's head is ...