Cervical spondylotic myelopathy: a common cause of spinal cord dysfunction in older persons

Am Fam Physician. 2000 Sep 1;62(5):1064-70, 1073.


Cervical spondylotic myelopathy is the most common cause of spinal cord dysfunction in older persons. The aging process results in degenerative changes in the cervical spine that, in advanced stages, can cause compression of the spinal cord. Symptoms often develop insidiously and are characterized by neck stiffness, arm pain, numbness in the hands, and weakness of the hands and legs. The differential diagnosis includes any condition that can result in myelopathy, such as multiple sclerosis, amyotrophic lateral sclerosis and masses (such as metastatic tumors) that press on the spinal cord. The diagnosis is confirmed by magnetic resonance imaging that shows narrowing of the spinal canal caused by osteophytes, herniated discs and ligamentum flavum hypertrophy. Choice of treatment remains controversial, surgical procedures designed to decompress the spinal cord and, in some cases, stabilize the spine are successful in many patients.

Publication types

  • Review

MeSH terms

  • Aged
  • Amyotrophic Lateral Sclerosis / complications
  • Amyotrophic Lateral Sclerosis / diagnosis
  • Cervical Vertebrae*
  • Diagnosis, Differential
  • Humans
  • Hypesthesia / etiology
  • Magnetic Resonance Imaging
  • Muscle Weakness / etiology
  • Neck Pain / etiology
  • Neuralgia / etiology
  • Neurosurgical Procedures
  • Patient Education as Topic
  • Spinal Cord / physiopathology*
  • Spinal Osteophytosis / complications*
  • Spinal Osteophytosis / diagnosis*
  • Spinal Osteophytosis / physiopathology
  • Teaching Materials
  • Tomography, X-Ray Computed