Houston Methodist. Leading Medicine

Neck FAQ

Question:

I read my doctor's report on me and it said clinical diagnosis of cervical myelopathy. Order MRI to make the differential diagnosis. Can you please interpret this for me?

Answer:

Your physician will probably go over the results of your tests and answer any questions you may have. We can give you a little bit of information, to help you prepare for that meeting. Cervical myelopathy is a degenerative condition that occurs with aging. Adults affected most often are 50 years old and older. The term myelopathy refers to any problem that affects the spinal cord, but especially compression of the spinal cord. Cervical tells us the area affected is the cervical spine (neck region). There are several reasons why cord compression develops. Sometimes the posterior longitudinal ligament (PLL) along the back of the spine thickens and hardens. Without its normal flexibility, it can buckle and put pressure on the cord. Bone spurs, disc herniation, and spondylolysis can also apply pressure to the spinal cord. Spondylolysis refers to a defect (usually a fracture) in the par interarticularis, a supportive column of bone in the vertebra. The diagnosis of cervical myelopathy is a clinical diagnosis. That means in order to make the diagnosis, the physician relies on the patient's history, specific tests performed during the physical exam, and the results of advanced imaging studies. There isn't a blood test or other simple way to identify this condition. Patients with cervical myelopathy can experience a wide range of signs and symptoms. There can be difficulty walking, using the hands, bowel and bladder function, or even wasting of the muscles of the hands. When the muscles are affected, motor function, coordination, and muscle mass can change. Sometimes there is also a loss of normal sensation with numbness and tingling of the fingers and toes. In addition, there can be debilitating pain. There are other conditions that can cause similar symptoms such as stroke or multiple sclerosis. The differential diagnosis refers to the steps (tests and measures) needed to identify which specific cause is present. In the case of cervical myelopathy, the MRI can show changes in the shape of the spinal cord called deformation indicating pressure or compression. John M. Rhee, MD, et al. Prevalence of Physical Signs in Cervical Myelopathy. In Spine. April 20, 2009. Vol. 34. No. 9. Pp. 890-895.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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