Cervical Myelopathy ALSANGEDY

 The most serious consequence of

cervical intervertebral disk
BULLETS™
degeneration
FOR PACES
 Caused by arthritic changes FOR EASY PASSING PACES FROM
(spondylosis) of the cervical spine THE 1ST ATTEMPT
 Insidious onset Dr. Ibrahim Alsangedy
MRCP-UK, MRCEM-UK, MRCPE, AMC
 In persons aged 50-60 years CAT (AU), IDHA (USA), M.SC (ICU),
ADDM, HCQM
 Complete reversal is rare
 Sphincters Involvement is unusual
 Spurling sign - Radicular pain is
exacerbated by extension and
lateral bending of the neck toward
the side of the lesion
 Lhermitte sign - This generalized
electrical shock sensation is
associated with neck flexion
 Hoffman sign - Reflex contraction
of the thumb and index finger
occurs in response to nipping of
the middle finger
 A characteristically broad-based,
stooped, and spastic gait
 Distal weakness
Workup Differential Diagnoses Management
 No Laboratory Studies specific  Adhesive Capsulitis  Immobilization of the cervical
findings are present spine is the mainstay of
 Brown-Sequard Syndrome conservative treatment for
 Plain cervical radiography is patients with severe cervical
routine in every patient with  Carpal Tunnel Syndrome spondylosis with evidence of
suspected cervical Myelopathy myelopathy
 Central Cord Syndrome
 Myelography, with computed  A program of isometric
tomography (CT) scanning  Cervical Disc Disease cervical exercises may help
to limit the loss of muscle
 MRI is the best way to visualize  Cervical Myofascial Pain tone that results from the use
the spinal cord of more restrictive orthoses
 Cervical Sprain and Strain
 Electromyography is useful in  Neck and upper back
evaluating radiculopathy  Chronic Pain Syndrome stretching exercises, as well
as light aerobic activities, also
 Somatosensory evoked  Diabetic Neuropathy are recommended
potential (SSEP) responses are
delayed or have a low  Multiple Sclerosis  Indications for Surgical
amplitude Intervention:
 Neoplastic Brachial Plexopathy  Progressive neurologic
 Cortical motor evoked deficits
potentials (MEP) is more  Osteoporosis and Spinal Cord  Compression of the
sensitive than SSEPs in Injury cervical nerve root
evaluating spinal cord and/or spinal cord
dysfunction  Radiation-Induced Brachial  Intractable pain
Plexopathy