Presentation
An element of developmental stenosis is present in a review of twelve patients presenting with cervical spondylotic myelopathy. [onlinelibrary.wiley.com]
Hoffman sign, if present, has been shown to positively correlate with CSM. 11 A Babinski sign, ankle clonus, and Lhermitte phenomenon should be documented, if present. [now.aapmr.org]
The clinical diagnosis of cervical spondylotic myelopathy can be difficult because of the multiple potential causes of similar symptoms and the variable presentations. [pietromortini.com]
Some patients present with an acute clinical course (mostly patients with significant but asymptomatic stenosis who suffer acute spinal cord compression after a trivial injury)[2]. [physio-pedia.com]
Congenital narrowing of cervical spinal canal Congenital stenosis of the cervical spine Prevalence: - Inheritance: - Age of onset: Adolescent, Adult ICD-10: Q06.8 OMIM: - UMLS: - MeSH: - GARD: - MedDRA: - The documents contained in this web site are presented [orpha.net]
Musculoskeletal
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Pseudoclaudication Syndrome
"Pseudoclaudication" syndrome produced by compression of the cauda equina. JAMA. 1968 Dec 9; 206 (11):2477–2481. [ PubMed ] [ Google Scholar ] Lassen NA. Control of cerebral circulation in health and disease. [ncbi.nlm.nih.gov]
Neurologic
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Quadriplegia
Cervical spinal stenosis with cord neurapraxia and transient quadriplegia. Determining the sagittal dimensions of the canal of the cervical spine. The reliability of ratios of anatomical measurements. Original Text by Clifford R. Wheeless, III, MD. [wheelessonline.com]
Guidelines for return to contact sports after transient quadriplegia. J. Neurosurg., v.80, n.3, p.592-94, 1994. [ Links ] 9. CORCORAN, T. A.; CANTU, R.C. Transient quadriplegia. SpineLine, v.1, n.2, p.11-12, 2000. [ Links ] 10. [scielo.br]
So problems like stenosis involving the cervical spine, again unlike the lumbar spine, can result in devastating problems such as quadriplegia. The symptoms of cervical stenosis can be subtle and are often missed, even by health care providers. [seniorliving.org]
a hybrid procedure can be performed in the part that is not unstable (Case 2) Case 1: Laminoplasty for acute spinal cord injury 14 year old boy who was checked to ground playing basketball, started with hand and leg weakness and progressed to near quadriplegia [arthurjenkinsmd.com]
Neuropraxis of the cervical spinal cord with transient quadriplegia. J Bone Joint Surg Am 1986; 68:1354–1370 [Google Scholar] 6. Muhle C, Metzner J, Weinert D, et al. [ajronline.org]
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Lhermitte's Sign
The well-known "Lhermitte sign" does not occur constantly. Patients describe the attacks as a sudden generalized electric shock in the arms and trunk, particularly when the head is bent. Diagnosis "Cervical myelopathy" is a clinical diagnosis. [aerzteblatt.de]
Neurologic findings were significant, with upper and lower extremity hyperreflexia bilaterally and positive Romberg's test, Lhermitte's sign, and Hoffmann's sign. [en.wikibooks.org]
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Muscular Fasciculation
Spasticity, enhanced reflexes and pyramidal tract symptoms are characteristics of this disease, while muscular fasciculation is regarded as untypical. The disturbances in sensitivity are mostly unrelated to the dermatome. [aerzteblatt.de]
Workup
Electrophysiological parameters Patients receive an electrophysiological workup at t0 and t3. [josr-online.biomedcentral.com]
X-Ray
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Cervical Spine X-Ray
Often, cervical stenosis with myelopathy is associated with some degree of cervical instability, and flexion/extension lateral cervical spine x-rays are useful to rule out abnormal motion and instability. [spinepainbegone.com]
Treatment
Myelography and myelographic CT are still useful for decisions on operative treatment, especially in cases of moderate stenosis. This may, however, not apply to imagers operating at 0.5 Tesla as below. [ncbi.nlm.nih.gov]
Treatment options for spinal stenosis There are two treatment options available to help treat your cervical spinal stenosis: conservative treatment and surgical treatment. [laserspineinstitute.com]
Nonsurgical Treatments Surgical Treatments Ohio State performs innovative research in the laboratory, as well as through clinical trials. [wexnermedical.osu.edu]
Prognosis
Advanced age of the patients and a moderately long history of CSM do not usually imply a poor prognosis. The control series show that cord compression signs are not present even with a sagittal diameter of 9 mm. [onlinelibrary.wiley.com]
Diagnosis, Prognosis, and Treatment for Congenital Spinal Stenosis Congenital spinal stenosis tends to worsen progressively with age. Many people born with the condition may develop symptoms as early as the age of 15. [spinaldisorders.com]
NATURAL HISTORY AND PROGNOSIS OF CERVICAL SPONDYLOSIS. Br Med J. 1963 Dec 28; 2 (5373):1607–1610. [ PMC free article ] [ PubMed ] [ Google Scholar ] Lurati M, Mertens HG. [ncbi.nlm.nih.gov]
Selected Bibliography Lees F, Turner JWA: Natural history and prognosis of cervical spondylosis. BMJ 1963;2:1607. [uscspine.com]
Etiology
Etiology Primary stenosis is uncommon, occurring in only 9% of cases. [emedicine.medscape.com]
[…] in the study of twins Cumulative trauma can lead to the progression of the disease Osteoporosis can be a contributing factor Cigarette smoking in several epidemiological studies has been shown to lead to back pain and degenerative spinal diseases.[4] Etiology [physio-pedia.com]
Absolute stenosis is defined as 1 Etiology Acquired cervical stenosis results from age-related degenerative disk and facet disease with associated uncinate process hypertrophy, ligamentum flavum thickening, and buckling of the posterior longitudinal ligament [now.aapmr.org]
Etiologic diagnosis of ischemic stroke subtypes with plasma biomarkers. Stroke, 2008. 39(8): p. 2280-7. 10.Nedeltchev, K., L. Remonda, and G. [neuro.dxy.cn]
Epidemiology
However, no epidemiologic data of the CSC based on a population-based cohort are available. [ncbi.nlm.nih.gov]
A prospective, population-based study of the demographics, epidemiology, management, and outcome of out-of-hospital pediatric cardiopulmonary arrest. Ann Emerg Med. [books.google.it]
In the cervical spine, segments C5-6 and C6-7 are often affected.[4] Epidemiology Cervical spine stenosis appears to be very common and it estimated that cervical stenosis is present in: 4.9% of the adult population, 6.8% of the population fifty years [physio-pedia.com]
The epidemiological references in USA demonstrate that spinal injuries during physical activity without supervision can reach 10% in activities considered as recreational as surf, diving, and others. [scielo.br]
"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. Vokshoor A (February 14, 2010). [en.wikipedia.org]
Pathophysiology
Many theories regarding the pathophysiology of spinal stenosis suggest a number of confluent mechanisms. [physio-pedia.com]
The pathophysiology of spinal vascular malformations. J Neurol Sci. 1974 Oct; 23 (2):255–263. [ PubMed ] [ Google Scholar ] BOIJSEN E. The cervical spinal canal in intraspinal expansive processes. [ncbi.nlm.nih.gov]
Neurological manifestations of cervical spondylosis: an overview of signs, symptoms, and pathophysiology. Neurosurgery 2007; 60: S14–20 CrossRef PubMed 23. Rao R. [springermedizin.de]
For this reason, the pathophysiology must be considered when selecting the suitable surgical procedure. [aerzteblatt.de]
SPECT bone scintigraphy is sensitive to diseases that actively affect bone pathophysiology, but spatial resolution is limited. Positive results are more likely for lesions that have osteoblastic activity. [emedicine.medscape.com]
Prevention
The goal of surgery for cervical stenosis with myelopathy is to relieve compression of the spinal cord to prevent further damage. [spine-health.com]
Surgery may be required to prevent further damage to the cord itself and prevent paralysis. In the lower back, spinal stenosis symptoms may cause radiculopathy. This may result in pain in a leg with weakness, numbness and tingling. [texasspineandneurosurgerycenter.com]
Usually spinal stenosis prevents you from walking beyond a certain distance. You then have to stop because of increasing pain and numbness in one or both of your legs. The symptoms can also occur when standing. [patient.info]
The surgeon will decompress the affected nerve in your spinal cord that is causing your pain, and then insert an implant to stabilize your spine and help prevent future narrowing of your spinal canal. [laserspineinstitute.com]