Degenerative cervical myelopathy

Question 1

What is this?

Answer 1

the most common cause of acquired spinal cord compromise.

Question 2

What is a risk factor

Answer 2

smoking

Question 3

What are the symptoms?

Answer 3

Pain (affecting the neck, upper or lower limbs)
Loss of motor function (loss of digital dexterity, preventing simple tasks such as holding a fork or doing up their shirt buttons, arm or leg weakness/stiffness leading to impaired gait and imbalance
Loss of sensory function causing numbness
Loss of autonomic function (urinary or faecal incontinence and/or impotence) - these can occur and do not necessarily suggest cauda equina syndrome in the absence of other hallmarks of that condition

Question 4

What is the gold standard test?

Answer 4

MRI cervical spine

Question 5

What is the treatment?

Answer 5

All patients with degenerative cervical myelopathy should be urgently referred for assessment by specialist spinal services (neurosurgery or orthopaedic spinal surgery). This is due to the importance of early decompression

The timing of surgery is important, as any existing spinal cord damage can be permanent.

Early treatment (within 6 months of diagnosis) offers the best chance of a full recovery but at present, most patients are presenting too late.