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Semin Neurol 2021; 41(03): 239-246
DOI: 10.1055/s-0041-1725144
Review Article

Cervical and Thoracic Spondylotic Myelopathies

Ligia V. Onofrei
1   Department of Neurology, University of Utah, Salt Lake City, UT
,
A. Michael Henrie
2   Department of Physical Medicine and Rehabilitation, University of Utah, UT
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Abstract

Spondylotic myelopathies are among the most common disorders of the spine, yet the clinical and treatment approach is far from standardized. This article discusses our current understanding of the epidemiology, pathophysiology, clinical assessment, natural history, and treatment options in degenerative myelopathies of the cervical and thoracic spine. We additionally review diagnostic modalities including imaging modalities of the spine and neurophysiological tools such as electromyography/nerve conduction studies, somatosensory-evoked potentials, and motor-evoked potentials. Assessment instruments that can be used for the assessment of myelopathies are reviewed, including the Japanese Orthopedic Association (JOA) score, modified-JOA scale, Nurick scale, nine-hole peg test, and 30-m walking test. We also review common disorders that mimic spondylotic myelopathies, as well as helpful diagnostic clues in differentiating spondylotic and nonspondylotic myelopathies.

Keywords

cervical myelopathy - thoracic myelopathy - degenerative myelopathies


Publikationsverlauf

Artikel online veröffentlicht:
19. Mai 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Bartleson JD, Deen HG. Spine Disorders: Medical and Surgical Management. Cambridge; New York, NY:: Cambridge University Press; 2009
    CrossrefGoogle Scholar
  • 2 Yamaguchi S, Mitsuhara T, Abiko M, Takeda M, Kurisu K. Epidemiology and overview of the clinical spectrum of degenerative cervical myelopathy. Neurosurg Clin N Am 2018; 29 (01) 1-12
    CrossrefPubMedGoogle Scholar
  • 3 Aizawa T, Sato T, Tanaka Y. et al. Thoracic myelopathy in Japan: epidemiological retrospective study in Miyagi Prefecture during 15 years. Tohoku J Exp Med 2006; 210 (03) 199-208
    CrossrefPubMedGoogle Scholar
  • 4 Karadimas SK, Erwin WM, Ely CG, Dettori JR, Fehlings MG. Pathophysiology and natural history of cervical spondylotic myelopathy. Spine 2013; 38 (22, Suppl 1): S21-S36
    CrossrefPubMedGoogle Scholar
  • 5 Wilson JR, Tetreault LA, Kim J. et al. State of the art in degenerative cervical myelopathy: an update on current clinical evidence. Neurosurgery 2017; 80 (3S): S33-S45
    CrossrefPubMedGoogle Scholar
  • 6 Jenkins TJ, Mai HT, Burgmeier RJ, Savage JW, Patel AA, Hsu WK. The triangle model of congenital cervical stenosis. Spine 2016; 41 (05) E242-E247
    CrossrefPubMedGoogle Scholar
  • 7 Hou X, Sun C, Liu X. et al. Clinical features of thoracic spinal stenosis-associated myelopathy: a retrospective analysis of 427 cases. Clin Spine Surg 2016; 29 (02) 86-89
    CrossrefPubMedGoogle Scholar
  • 8 Dvorak J, Sutter M, Herdmann J. Cervical myelopathy: clinical and neurophysiological evaluation. Eur Spine J 2003; 12 (Suppl. 02) S181-S187
    CrossrefPubMedGoogle Scholar
  • 9 Amenta PS, Ghobrial GM, Krespan K, Nguyen P, Ali M, Harrop JS. Cervical spondylotic myelopathy in the young adult: a review of the literature and clinical diagnostic criteria in an uncommon demographic. Clin Neurol Neurosurg 2014; 120: 68-72
    CrossrefPubMedGoogle Scholar
  • 10 Chikuda H, Seichi A, Takeshita K. et al. Correlation between pyramidal signs and the severity of cervical myelopathy. Eur Spine J 2010; 19 (10) 1684-1689
    CrossrefPubMedGoogle Scholar
  • 11 Takayama H, Muratsu H, Doita M, Harada T, Kurosaka M, Yoshiya S. Proprioceptive recovery of patients with cervical myelopathy after surgical decompression. Spine 2005; 30 (09) 1039-1044
    CrossrefPubMedGoogle Scholar
  • 12 Wang Z, Sakakibara T, Kasai Y. Overactive bladder in cervical spondylotic myelopathy. J Orthop Sci 2014; 19 (01) 22-25
    CrossrefPubMedGoogle Scholar
  • 13 Hehir MK, Figueroa JJ, Zynda-Weiss AM, Stanton M, Logigian EL. Unexpected neuroimaging abnormalities in patients with apparent C8 radiculopathy: broadening the clinical spectrum. Muscle Nerve 2012; 45 (06) 859-865
    CrossrefPubMedGoogle Scholar
  • 14 Olindo S, Signate A, Richech A. et al. Quantitative assessment of hand disability by the Nine-Hole-Peg test (9-HPT) in cervical spondylotic myelopathy. J Neurol Neurosurg Psychiatry 2008; 79 (08) 965-967
    CrossrefPubMedGoogle Scholar
  • 15 Oxford Grice K, Vogel KA, Le V, Mitchell A, Muniz S, Vollmer MA. Adult norms for a commercially available Nine Hole Peg Test for finger dexterity. Am J Occup Ther 2003; 57 (05) 570-573
    CrossrefPubMedGoogle Scholar
  • 16 Singh A, Crockard HA. Quantitative assessment of cervical spondylotic myelopathy by a simple walking test. Lancet 1999; 354 (9176): 370-373
    CrossrefPubMedGoogle Scholar
  • 17 Bohm PE, Fehlings MG, Kopjar B. et al. Psychometric properties of the 30-m walking test in patients with degenerative cervical myelopathy: results from two prospective multicenter cohort studies. Spine J 2017; 17 (02) 211-217
    CrossrefPubMedGoogle Scholar
  • 18 Siasios ID, Spanos SL, Kanellopoulos AK. et al. The role of gait analysis in the evaluation of patients with cervical myelopathy: a literature review study. World Neurosurg 2017; 101: 275-282
    CrossrefPubMedGoogle Scholar
  • 19 Kato S, Oshima Y, Oka H. et al. Comparison of the Japanese Orthopaedic Association (JOA) score and modified JOA (mJOA) score for the assessment of cervical myelopathy: a multicenter observational study. PLoS One 2015; 10 (04) e0123022
    CrossrefPubMedGoogle Scholar
  • 20 Tetreault L, Kopjar B, Nouri A. et al. The modified Japanese Orthopaedic Association scale: establishing criteria for mild, moderate and severe impairment in patients with degenerative cervical myelopathy. Eur Spine J 2017; 26 (01) 78-84
    CrossrefPubMedGoogle Scholar
  • 21 Vitzthum HE, Dalitz K. Analysis of five specific scores for cervical spondylogenic myelopathy. Eur Spine J 2007; 16 (12) 2096-2103
    CrossrefPubMedGoogle Scholar
  • 22 Flanagan EP, Krecke KN, Marsh RW, Giannini C, Keegan BM, Weinshenker BG. Specific pattern of gadolinium enhancement in spondylotic myelopathy. Ann Neurol 2014; 76 (01) 54-65
    CrossrefPubMedGoogle Scholar
  • 23 Simon NG, Lomen-Hoerth C, Kiernan MC. Patterns of clinical and electrodiagnostic abnormalities in early amyotrophic lateral sclerosis. Muscle Nerve 2014; 50 (06) 894-899
    CrossrefPubMedGoogle Scholar
  • 24 Hammad M, Silva A, Glass J, Sladky JT, Benatar M. Clinical, electrophysiologic, and pathologic evidence for sensory abnormalities in ALS. Neurology 2007; 69 (24) 2236-2242
    CrossrefPubMedGoogle Scholar
  • 25 Magge SN, Smyth MD, Governale LS. et al. Idiopathic syrinx in the pediatric population: a combined center experience. J Neurosurg Pediatr 2011; 7 (01) 30-36
    CrossrefPubMedGoogle Scholar
  • 26 Milhorat TH, Chou MW, Trinidad EM. et al. Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery 1999; 44 (05) 1005-1017
    CrossrefPubMedGoogle Scholar
  • 27 Lyu RK, Huang YC, Wu YR. et al. Electrophysiological features of Hirayama disease. Muscle Nerve 2011; 44 (02) 185-190
    CrossrefPubMedGoogle Scholar
  • 28 Verschueren A, Azulay JP, Attarian S, Boucraut J, Pellissier JF, Pouget J. Lewis-Sumner syndrome and multifocal motor neuropathy. Muscle Nerve 2005; 31 (01) 88-94
    CrossrefPubMedGoogle Scholar
  • 29 Krings T, Geibprasert S. Spinal dural arteriovenous fistulas. AJNR Am J Neuroradiol 2009; 30 (04) 639-648
    CrossrefPubMedGoogle Scholar
  • 30 Shiban E, Meyer B. Treatment considerations of cervical spondylotic myelopathy. Neurol Clin Pract 2014; 4 (04) 296-303
    CrossrefPubMedGoogle Scholar
  • 31 Xu N, Wang S, Yuan H, Liu X, Liu Z. Does dynamic supine magnetic resonance imaging improve the diagnostic accuracy of cervical spondylotic myelopathy? A review of the current evidence. World Neurosurg 2017; 100: 474-479
    CrossrefPubMedGoogle Scholar
  • 32 Liu Y, Kong C, Cui L. et al. Correlation between diffusion tensor imaging parameters and clinical assessments in patients with cervical spondylotic myelopathy with and without high signal intensity. Spinal Cord 2017; 55 (12) 1079-1083
    CrossrefPubMedGoogle Scholar
  • 33 Clarke E, Robinson PK. Cervical myelopathy: a complication of cervical spondylosis. Brain 1956; 79 (03) 483-510
    CrossrefPubMedGoogle Scholar
  • 34 Rhee J, Tetreault LA, Chapman JR. et al. Nonoperative versus operative management for the treatment degenerative cervical myelopathy: an updated systematic review. Global Spine J 2017; 7 (3, Suppl): 35S-41S
    CrossrefPubMedGoogle Scholar
  • 35 Witiw CD, Tetreault LA, Smieliauskas F, Kopjar B, Massicotte EM, Fehlings MG. Surgery for degenerative cervical myelopathy: a patient-centered quality of life and health economic evaluation. Spine J 2017; 17 (01) 15-25
    CrossrefPubMedGoogle Scholar
  • 36 Kadaňka Z, Bednařík J, Novotný O, Urbánek I, Dušek L. Cervical spondylotic myelopathy: conservative versus surgical treatment after 10 years. Eur Spine J 2011; 20 (09) 1533-1538
    CrossrefPubMedGoogle Scholar
  • 37 Tetreault LA, Côté P, Kopjar B, Arnold P, Fehlings MG. AOSpine North America and International Clinical Trial Research Network. A clinical prediction model to assess surgical outcome in patients with cervical spondylotic myelopathy: internal and external validations using the prospective multicenter AOSpine North American and international datasets of 743 patients. Spine J 2015; 15 (03) 388-397
    CrossrefPubMedGoogle Scholar
  • 38 Fehlings MG, Barry S, Kopjar B. et al. Anterior versus posterior surgical approaches to treat cervical spondylotic myelopathy: outcomes of the prospective multicenter AOSpine North America CSM study in 264 patients. Spine 2013; 38 (26) 2247-2252
    CrossrefPubMedGoogle Scholar
  • 39 Kalsi-Ryan S, Singh A, Massicotte EM. et al. Ancillary outcome measures for assessment of individuals with cervical spondylotic myelopathy. Spine 2013; 38 (22, Suppl 1): S111-S122
    CrossrefPubMedGoogle Scholar
  • 40 Toledano M, Bartleson JD. Cervical spondylotic myelopathy. Neurol Clin 2013; 31 (01) 287-305
    CrossrefPubMedGoogle Scholar