Mimickers of Cervical Spondylotic Myelopathy

Kouri, Anthony; Tanios, Mina; Herron, Joseph S.; Cooper, Maxwell A.; Khan, Mustafa

doi:10.2106/jbjs.rvw.17.00176

Cited by 4 publications

(4 citation statements)

References 64 publications

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“…In addition, GBS may involve cranial nerves, whereas cervical myelopathy does not. Dysautonomia and respiratory muscle involvement are the primary cause of morbidity and mortality associated with GBS 6 . Given the reliance on the history and physical examination for a differential diagnosis that includes cervical myelopathy, a thorough examination and a high index of suspicion are essential for an accurate diagnosis and appropriate treatment.…”

Section: Discussionmentioning

confidence: 99%

Cervical Myelopathy with Concomitant Guillain-Barré Syndrome

Neaville,

Khairy,

Mierke

et al. 2023

JBJS Case Connector

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Case: We present a case of a 67-year-old female patient with concomitant cervical spondylotic myelopathy (CSM) and Guillain-Barré syndrome (GBS). Surgical intervention, including cervical decompression and arthrodesis, was performed to address cervical myelopathy symptoms. Despite initial improvement, the patient's motor function deteriorated, leading to the diagnosis of GBS. The patient's hospital course was protracted with a complicated recovery. Conclusion: This case emphasizes the clinical details of coexisting CSM and GBS, highlighting the importance of diagnosing and considering demyelinating diseases when determining the optimal timeline for surgical intervention. These findings inform decision-making for clinicians encountering similar patient presentations.

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Section: Discussionmentioning

confidence: 99%

Cervical Myelopathy with Concomitant Guillain-Barré Syndrome

Neaville,

Khairy,

Mierke

et al. 2023

JBJS Case Connector

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“…The degree of the degenerative changes of the intervertebral disc, cord compression, and hypertrophy of the ligamentum flavum can be observed on an MRI. Several studies revealed a correlation between signal changes in the spinal cord and the degree of cervical myelopathy [10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Sharp, intense, multisegmented increased signal intensity in the spinal cord at T2-weighted images is correlated with suboptimal outcomes [21].…”

Section: Diagnostic Testsmentioning

confidence: 99%

“…Symptoms and signs of myelopathy may vary depending on the involved cervical segment and the degree of compression. Additionally, patients may exhibit gait disturbance, spasticity, and bladder or bowel dysfunction, along with increased cord compression severity [ 17 ].…”

Section: Clinical Symptoms and Signsmentioning

confidence: 99%

Update of the Natural History, Pathophysiology, and Treatment Strategies of Degenerative Cervical Myelopathy: A Narrative Review

Kim

Kang²,

Choi

2023

Asian Spine J

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Cervical myelopathy is a clinical syndrome resulting in symptoms of neurologic deficits due to prolonged spinal cord compression or ischemia in the cervical spine. Spinal cord compression can be caused by ossification of the posterior longitudinal ligament and hypertrophy of ligamentun flavum in addition to degenerative cervical spondylosis, degenerative disc disease, and progressive cervical kyphosis. Degenerative cervical myelopathy (DCM) is a series of disease entities caused by spinal cord compression by various nontraumatic and non-infectious causes. The pathophysiology of DCM includes spinal cord structure and function abnormalities caused by both static and dynamic factors. Surgical decompression for patients with moderate to severe cervical myelopathy not only inhibits the progression of neurological deterioration, but also improves functional status, pain, and quality of life. However, the role of nonsurgical treatment in patients with mild spinal cord compression is controversial. In general, patients with cervical myelopathies who do not undergo surgery have a poor prognosis. Appropriate surgical treatment is recommended when spinal cord compression is confirmed on image study in patients with reasonable symptoms of cervical myelopathy. The patient's overall health, degree of compression, presence of concurrent cervical radiculopathy, and cervical spine alignment, in addition to lesion location and etiology, should be considered when determining an appropriate surgical procedure. This review covers the updated issues, including pathophysiology, clinical manifestations, differential diagnosis, and available treatments for DCM.

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“…Initially, patients present with symptoms of paresthesia, dysesthesia, diplopia, urinary incontinence, and dizziness; however, as the disease progresses, paresthesia affects the pelvis, abdomen, or chest in an ascending pattern or shows unilateral leg numbness that spreads to the contralateral leg. Oligoclonal bands were detected in >90% of patients with MS and an increased immunoglobulin G index was observed in >60% of cerebrospinal fluid analyses [ 29 ].…”

Section: Differential Diagnosismentioning

confidence: 99%

Degenerative Cervical Myelopathy: Pathophysiology and Current Treatment Strategies

Choi

Kang

2020

Asian Spine J

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Chronic compression or ischemia of the spinal cord in the cervical spine causes a clinical syndrome known as cervical myelopathy. Recently, a new term “degenerative cervical myelopathy (DCM)” was introduced. DCM encompasses spondylosis, intervertebral disk herniation, facet arthrosis, ligamentous hypertrophy, calcification, and ossification. The pathophysiology of DCM includes structural and functional abnormalities of the spinal cord caused by static and dynamic factors. In nonoperative patients, cervical myelopathy has a poor prognosis. Surgical treatments, such as anterior or posterior decompression accompanying arthrodesis, arthroplasty, or laminoplasty, should be considered for patients with chronic progressive cervical myelopathy. Surgical decompression can prevent the progression of myelopathy and improve the neurologic status, functional outcomes, and quality of life, irrespective of differences in medical systems and sociocultural determinants of health. The anterior surgical approach to the cervical spine has the advantage of removing or floating the intervertebral disk, osteophytes, and ossification of the posterior longitudinal ligament that compress the spinal cord directly. The posterior surgical approach to the cervical spine is mainly used for multisegment spinal cord compression in patients with cervical lordosis. In this review article, we addressed the pathophysiology, clinical manifestations, differential diagnosis, and treatment options for DCM.

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Mimickers of Cervical Spondylotic Myelopathy

Cited by 4 publications

References 64 publications

Cervical Myelopathy with Concomitant Guillain-Barré Syndrome

Cervical Myelopathy with Concomitant Guillain-Barré Syndrome

Update of the Natural History, Pathophysiology, and Treatment Strategies of Degenerative Cervical Myelopathy: A Narrative Review

Degenerative Cervical Myelopathy: Pathophysiology and Current Treatment Strategies

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