Cervical cord compression is a term denoting a pathological process of the cervical spinal cord in which different pathological entities cause its compression. Cervical spondylotic myelopathy (CSM), a consequence of a degenerative process of the vertebrae and surrounding connective tissue that is primarily seen in elderly persons, is one of the most frequently mentioned causes [1] [2] [3]. The clinical presentation of cervical cord compression, particularly when CSM is the underlying culprit, can have an insidious course with early symptoms being mild neck stiffness and a limited range of neck motion, reduced hand dexterity, minor balance issues, clumsiness, and difficulties with performing easy tasks (handwriting, use of keys, holding the handrail while climbing up the stairs, or text messaging) [1] [3] [4]. It is not uncommon for patients to neglect early symptoms [4], but as the severity of compression increases more pronounced manifestations develop. Pain in the upper extremity, particularly the shoulder, either described as stabbing or dull can appear along with hand numbness [1] [3] [4]. Paresthesias and weakness eventually arise. A more severe form of cervical cord compression leads to inadequate sphincter control and paralysis [3] [4]. In rare cases, lesion of the ascending spinothalamic tract might cause referred pain to the lower back or the lower extremities termed funicular leg pain [2].

• Difficulty Walking

  Cervical myelopathy is a syndrome of difficulty walking, hand clumsiness, arm weakness, and/or numbness/tingling caused by compression of the spinal cord. [uncmedicalcenter.org]

  Spinal cord compression can cause neurologic symptoms—such as pain, numbness, or difficulty walking. Your spinal cord is the conduit that enables communication between your brain and body. [spineuniverse.com]

  Cervical Cord Compression Symptoms Cervical cord compression symptoms may include heavy feeling in the arms and legs, cervical pain that is referred to the arm, shooting pains in the arms and legs, and/or difficulty walking and performing activities involving [emoryhealthcare.org]

  Difficulty grasping. Loss of balance and coordination. Difficulty walking Loss of fine motor skills. Difficulty writing, buttoning your clothes, or handling a knife and fork. [directorthocare.com]

  In other situations, cervical stenosis with myelopathy may present itself in symptoms that include a heavy feeling in the arms and legs, cervical pain that is referred to the arm, shooting pains in the arms and legs, and/or difficulty walking and performing [spine-health.com]

• Fatigue

  […] used to evaluate fatigue. [painscience.com]

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  Further, he noted that when he surgically decompressed severe, comorbid myelopathy, FM symptoms (allodynia, fatigue, central sensitization, pain, dyscognition, sleep disturbance) often abated. 14 Similar observations were made for FM combined with Chiari [practicalpainmanagement.com]

  This helps to alleviate fatigue and relieves muscle pain. Safe and Secure Payments. Easy returns. 100% Authentic products. [flipkart.com]

• Unconsciousness

  These researchers are obviously heavily invested in the idea of HBOT, and the more complicated the study, the more ways there are to unconsciously distort the experiment and its results. [painscience.com]

• Neck Pain

  Case Report: A 74-year-old woman presented to our emergency department with sudden onset of right neck pain when extending the neck. The pain mimicked an electric shock and radiated to the left shoulder. [tmu.pure.elsevier.com]

  The most common causes of neck pain are soft-tissue abnormalities due to injury or prolonged wear-and-tear. In rare instances, infection or tumors may cause neck pain. [shorelineortho.com]

  The most common and obvious symptoms of cervical degenerative disc disease are neck pain and a stiff neck. [webmd.com]

  CASE REPORT: A 74-year-old woman presented to our emergency department with sudden onset of right neck pain when extending the neck. The pain mimicked an electric shock and radiated to the left shoulder. [ncbi.nlm.nih.gov]

• Spine Pain

  Bending your neck forward (flexing) may cause electrical-like sensations that move down your spine. Pain may spread from your neck to your arms and fingers. [fixbones.com]

  You may not be able to avoid pain, but you will at least feel like you have some control over your life. Find the right mattress. Changing your mattress can help ease some of your spine pain. Look for a mattress that is not too firm or too soft. [verywellhealth.com]

• Fear

  Despite their slightly elevated risk, patients with stable mild to moderate symptoms should be able to live without severe restrictions and continue to engage in enjoyable activities without fearing a catastrophe. [americannursetoday.com]

  While fear and hypervigilance may erode quality of life, the pure hypochondriac is not suffering from a medical problem — not yet anyway. It’s a mental illness. [painscience.com]

• Urinary Incontinence

  When urinary incontinence starts or when patients become dependent on a wheel chair for long period of time, the chance that surgery will help decreases. [spinedoctormiami.com]

• Hyperreflexia

  Two patients did not show satisfactory improvement after the decompression of the entrapment lesions, and six patients had hyperreflexia of lower limbs. [ncbi.nlm.nih.gov]

  Several findings indicative of an ongoing pathological process involving the cervical spinal cord are: Hyperreflexia - A brisk triceps reflex accompanied by the absence of biceps and supinator reflexes are considered to be pathognomonic findings of cervical [symptoma.com]

  Subacute or chronic compression may begin with local back pain, often radiating down the distribution of a nerve root (radicular pain), and sometimes hyperreflexia and loss of sensation. Sensory loss may begin in the sacral segments. [msdmanuals.com]

  There will be upper motor neurone signs present (as opposed to the lower signs seen in peripheral nerve compression or cauda equina sydrome), including hypertonia, hyperreflexia*, Babinski’s sign, and clonus (present below the level of the lesion). [teachmesurgery.com]

• Confusion

  Shoulder problems may sometimes be confused with pain due to pressure on the nerve roots, and a shoulder ultrasound and/or MRI may be ordered, or an orthopaedic opinion obtained. [precisionneurosurgery.com.au]

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  In addition, patients often confuse their symptoms with prior episodes of back pain or choose to downplay the symptoms because they assume the pain may be a sign of progressive cancer. [cancernetwork.com]

  Multiple sclerosis and amyotrophic lateral sclerosis are two conditions which can be confused for cervical spondylotic myelopathy. MRI is in multiple sclerosis would identify demyelination in the spinal cord and cerebrum. [boneandspine.com]

  The term “spondylosis” is confusing and seems to be a ... 9 Managing Common Musculoskeletal Conditions by Physiotherapy ... Degeneration of the spinal joints is known as spondylosis. [educalingo.com]

• Long Tract Signs

  RESULTS: Both the Chiari I and cervical compression groups had long tract signs evident on clinical neurological examination. [ncbi.nlm.nih.gov]

  tract signs, ambulatory Class IIIB Objective weakness, long tract signs, non-ambulatory Japanese Orthopaedic Association Classification A point scoring system (17 total) based on function in the following categories upper extremity motor function lower [orthobullets.com]

• Spastic Paraplegia

  View/Print Table TABLE 4 Conditions That Mimic Cervical Spondylotic Myelopathy on Presentation Amyotrophic lateral sclerosis Extrinsic neoplasia (metastatic tumors) Hereditary spastic paraplegia Intrinsic neoplasia (tumors of spinal cord parenchyma) Multiple [aafp.org]

  Other conditions like primary spinal cord tumors, syringomyelia, metastatic tumors, subacute combined degeneration of the spinal cord (vitamin B12 deficiency), hereditary spastic paraplegia, normal pressure hydrocephalus, and spinal cord infarction can [boneandspine.com]

• Decreased Proprioception

  Table 1 – Signs/symptoms of cord compression New or worsening back pain Weakness Loss of sensation in affected limbs Decreased proprioception Numbness / tingling / coldness Urinary retention / constipation Ataxia / spasticity Bowel / bladder incontinence [oncolink.org]

In order to make the diagnosis of cervical cord compression and establish the underlying cause, a comprehensive clinical approach is necessary. A properly conducted neurological examination is the crucial step for raising suspicion toward this entity [1] [3] [4] [5]. Several findings indicative of an ongoing pathological process involving the cervical spinal cord are [1] [3] [4] [5]:

• Hyperreflexia - A brisk triceps reflex accompanied by the absence of biceps and supinator reflexes are considered to be pathognomonic findings of cervical spondylotic myelopathy associated with cervical spondylosis at the C5-C6 interspace [1].
• Limited neck motion and pain - Extension of the neck is almost universally limited [4]. Lhermitte's sign, a generalized shock-like sensation produced after neck flexion, is another important sign of cervical cord compression [1].
• Gait changes - A positive Romberg test (the patient loses balance while standing with closed eyes and arms being stretched anteriorly) and abnormal findings during walking tests (heel-to-toe tandem walking, heel-walking, and toe-walking) are frequently observed [1] [3].

As soon as a presumptive diagnosis is made, imaging studies must be employed. Plain radiography of the cervical spine is of limited use, which is why magnetic resonance imaging (MRI) and computed tomography (CT) are recommended [1] [3] [4] [5]. These procedures can identify intrinsic spinal cord changes, tumors, herniated discs, skeletal abnormalities (CT is favored over MRI in this case), and determine the exact cause of the compression [1] [3] [4] [6].

Cervical Cord Compression Treatment Conservative treatment like NSAIDS, activity modification and exercises may help relieve the arm pain. [emoryhealthcare.org]

The clinical presentation, radiologic features, and the operative treatment are summarized. The mechanism by which this lesion caused a severe cervical pain is discussed. [ncbi.nlm.nih.gov]

and arm pain after the fourth manipulative treatment. [chiro.org]

Nonsurgical Treatment In milder cases, initial treatment for CSM may be nonsurgical. The goal of nonsurgical treatment is to decrease pain and improve the patient's ability to perform daily activities. [orthoinfo.aaos.org]

High signal intensity of the spinal cord produced by compressive lesions appears to be an important indicator for predicting prognosis. Article History Published in print: 1989 [pubs.rsna.org]

Prognosis Prognosis is variable depending on the age of onset, rate of disease progression, age at initiation of ERT and on the quality of the medical care provided. [orpha.net]

Prognosis The spinal cord has very limited powers of regeneration. Prognosis for neurological deficit depends on the magnitude of the spinal cord damage present at the onset. [patient.info]

Prognosis depends greatly on the length of time of the cord impingement, the location of the mass in the spinal column, and the tissue type of the mass. Prognosis of SCC also depends on the functional status and length of survival after treatment. [medscape.com]

*Reflexes tend to be absent at the level of the lesion, as the lower motor neurone within the ventral horn is compressed, so producing a lower motor neurone deficit Any autonomic involvement is a late stage and therefore carries a worse prognosis. [teachmesurgery.com]

The etiology of upper cervical cord compression and radiological features of cervical OPLL was determined. [ncbi.nlm.nih.gov]

An evaluation for demyelinating, infectious, inflammatory, and neoplastic etiologies was unrevealing. A course of high-dose steroids provided only minimal clinical improvement. [neurology.org]

Imaging studies, magnetic resonance imaging (MRI) and computed tomography (CT), are frequently necessary to identify the underlying etiology. [symptoma.com]

Pathology Etiology There are numerous causes of cord compression. [radiopaedia.org]

A more slowly progressing form has been described as having later onset, mildly elevated glycosaminoglycans (generally Etiology The disorder is transmitted in an autosomal recessive manner and is caused by mutations in the ARSB gene, located in chromosome [orpha.net]

Reference article This is a summary article; read more in our article on spinal cord compression. anatomy spinal cord cauda equina epidemiology number of different causes different patient groups for each pathology may affect all age groups presentation [radiopaedia.org]

Summary Epidemiology Birth prevalence is between 1 in 43,261 and 1 in 1,505,160 live births. Clinical description The disorder shows a wide spectrum of symptoms from slowly to rapidly progressing forms. [orpha.net]

Gregory DCc aRhode Island Spine Center, Pawtucket, RI; and Department of Community Health, Brown University Medical School, Providence, RI bDepartment of Public Health Sciences and Epidemiology, John A. [sogacot.org]

"Epidemiology of cervical spondylotic myelopathy and its risk of causing spinal cord injury: a national cohort study". Neurosurgical Focus. 35 (1): E10. doi:10.3171/2013.4.FOCUS13122. PMID 23815246. ^ Shedid, Daniel; Benzel, Edward C. (2007). [en.wikipedia.org]

The inclusion of volunteers from the epidemiological study, complying with the criteria for the current study into prospective evaluation, had been planned beforehand. [onlinelibrary.wiley.com]

The pathophysiologic basis of such an abnormality was presumed to be myelomalacia or cord gliosis secondary to a long-standing compressive effect of the spinal cord. [ncbi.nlm.nih.gov]

The pathophysiologic basis of this high signal intensity area was oresumed to be edema or gliosis or myelomalacia secondary to a choronic compressive effect of the cervical spinal cord. [petit.lib.yamaguchi-u.ac.jp]

A team of internationally renowned authorities offer cutting-edge, in-depth guidance on the use of TMS to study brain physiology and pathophysiology as well as its current and future therapeutic uses. [books.google.com]

[…] case 1) thoracic or radicular pain constant, progressive, non-mechanical pain systemically unwell widespread neurological signs and symptoms power reduction: 80% of patients need help to mobilize loss of sensation: saddle anesthesia urinary retention pathophysiology [radiopaedia.org]

Pathophysiology of Cervical Spondylotic Myelopathy There are three important pathophysiologic factors in the development of cervical spondylotic myelopathy Static mechanical Osteophytic overgrowth of cervical spondylosis ventrally and buckling of ligamentum [boneandspine.com]

This is the first report of laminoplasty as a useful surgical approach for intraspinal exostosis to prevent postoperative cervical instability. [ncbi.nlm.nih.gov]

One must realize that the degenerative process can be managed, but it cannot be prevented by diet, exercise, or lifestyle changes. [gulfcoastspinecare.com]

Focused history and recognition of abnormal neurological signs by focused physical examination is crucial to preventing devastating morbidity. [bjgp.org]

Treatment of myelopathy is aimed at preventing the symptoms from getting worse and involves a surgical procedure. Often times, a disability that develops may not get better even with a surgery to take pressure off the spine. [beaconortho.com]

The following measures may help prevent SCIs: Proper safety practices during work and play can prevent many spinal cord injuries. Use protective equipment for any activity in which an injury is possible. [medlineplus.gov]

1. Young WF. Cervical spondylotic myelopathy: a common cause of spinal cord dysfunction in older persons. Am Fam Physician. 2000;62(5):1064-1070, 1073.
2. Chan CK, Lee HY, Choi WC, Cho JY, Lee SH. Cervical cord compression presenting with sciatica-like leg pain. Eur Spine J. 2011;20(Suppl 2):217-221.
3. Meyer F, Börm W, Thomé C. Degenerative Cervical Spinal Stenosis: Current Strategies in Diagnosis and Treatment. Dtsch Arztebl Int. 2008;105(20):366-372.
4. Lebl DR, Hughes A, Cammisa FP, O’Leary PF. Cervical Spondylotic Myelopathy: Pathophysiology, Clinical Presentation, and Treatment. HSS J. 2011;7(2):170-178.
5. Todd AG. Cervical spine: degenerative conditions. Curr Rev Musculoskelet Med. 2011;4(4):168-174.
6. Yeung JT, Johnson JI, Karim AS. Cervical disc herniation presenting with neck pain and contralateral symptoms: a case report. J Med Case Rep. 2012;6:166.