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SYMPOSIUM - CERVICAL SPONDYLOMYELOPATHY
Year : 2019  |  Volume : 2  |  Issue : 1  |  Page : 13-19

Clinical spectrum and importance of evaluation systems in degenerative cervical myeloradiculopathy


Department of Neurological Sciences, Division of Neurosurgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India

Correspondence Address:
Dr. Baylis Vivek Joseph
Department of Neurological Sciences, Division of Neurosurgery, Christian Medical College and Hospital, Vellore - 632 004, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/isj.isj_61_18

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Degenerative cervical myelopathy includes facet joint arthropathy and/or intervertebral disc prolapse, as well as aberration (hypertrophy, calcification, or ossification) in the ligamentum flavum, and/or posterior longitudinal ligament. Cervical spondylotic myelopathy and ossification of posterior longitudinal ligament are two major conditions under this spectrum. Patients with degenerative changes of the cervical spine can present with wide spectrum of symptoms and signs ranging from axial neck pain, radiculopathy or myelopathy. A combination of history, physical examination, and provocative tests such as Spurling's sign, shoulder abduction test, neck distraction test, Valsalva maneuver, Elvey's upper limb tension/brachial plexus tension test increase the likelihood of diagnosis of cervical radiculopathy. Myelopathy can manifest in the early stage as subtle changes in the upper limb dexterity or mild walking difficulty and in late stage with severe spasticity and flexor spasms. Clinicians are increasingly using quantitative or semi-quantitative scales of neurological impairment. However, there is no gold standard evaluation systems that can reliably assess disease severity.


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