Myelopathy is a lesion of the spinal cord that can occur with various diseases. More often than others, the cervical spinal cord is affected due to osteochondrosis and / or spondylosis (vertebrogenic cervical myelopathy). Myelopathy can develop with congenital stenosis of the spinal canal, craniovertebral anomaly, trauma or compression of the spinal cord by a tumor, also with cirrhosis of the liver, vitamin B, E deficiency, Lyme disease (borreliosis), rheumatoid arthritis, after chemotherapy (adriamycin, methotrexate, cytosine, vincristine ), radiation therapy, epidural anesthesia, or as a paraneoplastic syndrome.

The reasons

Cervical myelopathy occurs predominantly in middle-aged and elderly people. Most people develop changes (spondylosis and / or osteochondrosis) in the cervical spine with age, however, only in isolated cases does myelopathy occur, in the genesis of which compression of the spinal cord or its vessels by posterior osteophytes, thickened yellow ligament, herniated intervertebral discs is assumed.


The disease usually develops gradually. Many patients have pain and limitation of movement in the cervical spine. Spastic paresis and impaired deep sensation in the legs are typical, in combination with peripheral paresis in the arms. Lhermitte’s symptom is not often observed: a sensation of the passage of an electric current along the spine with irradiation to the arms and / or legs when the neck is flexed or extended. In rare cases, there are violations of the function of the pelvic organs. In many patients, myelopathy is combined with cervical radiculopathy.


MRI and myelography are the most informative. The composition of the cerebrospinal fluid is normal. An important role is played by spondylography, which allows, in particular, to identify a critical decrease in the sagittal diameter of the spinal canal. Differential diagnosis is carried out with a tumor, sarcoidosis, spinal form of multiple sclerosis, arteriovenous malformations of the spinal cord, funicular myelosis, hereditary (familial) spastic paraplegia of Strümpel.


Treatment is symptomatic. In discogenic myelopathy, if evidence of spinal cord compression is found, decompressive laminectomy is performed.

The prognosis for recovery is usually poor. However, in the most common cervical discogenic myelopathy, surgery can stabilize the process and even lead to significant improvement.

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