Cervical myelopathy is an insidious condition of the spinal cord, which if allowed to progress can cause permanent paralysis and even death. Cervical myelopathy is usually caused by what is know as Cervical Spondylotic Myelopathy (CSM) or trauma.

Cervical myelopathy is insidious, because unlike compressed nerves radiating from the spinal cord, the spinal cord feels no pain and it is difficult for patients to say when the symptoms begin. Cervical myelopathy is developed slowly, resulting from a spinal canal stenosis, which is a narrowing of the spinal canal. It is the slow degeneration of the spine called spondylosis, which causes the narrowing of the spinal canal.

Cervical myelopathy begins with compression of the spinal cord in the cervical spine. Edema begins to build about the spinal cord as the cord attempts to protect itself. This edema appears as white in a t2-weighted MRI images.

Early symptoms of cervical myelopathy:

• Heavy feeling in the legs
• Unable to walk at a brisk pace
• Gait disturbance, e.g. bilateral uncertainty when walking blindfolded.
• Deterioration in fine motor skills (such as handwriting or buttoning a shirt)
• Feelings of numbness, tingling, pins and needles, or shooting fire like pain in the arms and/or legs, when bending their head backward or far forward (known as Lermitte’s phenomenon).
• Reduced bladder control, or sexual disturbance, associated with the above.

Spinal nerves inside the spinal cord, which run from the brain to the legs will be affected. Thus these medical signs will become pathological:

Traumatic cervical myelopathy with spinal canal stenosis is usually diagnostic at the time of the trauma or is the result of acute disc herniation. The symptoms can be the same as cervical myelopathy caused from degenerative conditions.

Degenerative Disc Disease: Definition

Degenerative Disc Disease (DDD) (sometimes spelled Degenerative Disk Disease) is a major cause of back pain. It is a particular type of spondylosis, where the protein and collagen structures, particularly in cartilage, gradually deteriorate with age. The intervertebral discs are affected by spondylosis, because there are more than 60 bands of collagen fibers called lamellae, which encase the water-filled nucleus. The weakening of these bands and the annulus fibrosis leads to water loss in the nucleus, loss of disc height, the reduction of distance between vertebrae, and the increased probability of a herniated disc.

Facet Hypertrophy

Facet Hypertrophy: Definition

Facet Hypertrophy is an enlargement of the facet joint. It can increase to the point where
nerves in the spine come under pressure and can cause lateral recess stenosis with subsequent radiculopathy. The hypertrophic degenerated joint is also a pain generator of its own.

The inferior articular process of a vertebra with the superior spinal processes of the adjacent
lower vertebra forms a facet joint, also known as the zygapophysial joint. The facet joint is a synovial joint, as opposed to cartilaginous or fibrous joint. This means that the joint is
surrounded by a capsule, which is filled with lubricating fluid. The facet joint guides the flexion, extension and the rotation of the spine, while limiting motion in all directions to the appropriate degree.