ABSTRACT

Clinical presentation of cervical spondylotic myelopathy (CSM) is highly variable with some presenting with mild symptoms, whereas others may have severe disability. Those with severe disabling CSM often are dependent and require significant health-care and societal resources. CSM is caused by progressive compression of the spinal cord and/or nerve roots secondary most commonly to degenerative processes of the vertebral column. Specifically, neural compression can occur from various degenerative etiologies including acute or chronic disc herniation/protrusion, hypertrophy of the ligamentum flavum, facet joint degeneration and hypertrophy, and progressive osteophyte formation. As the spinal cord and nerve roots undergo acute and/or chronic compression, symptoms result from progressive neurologic dysfunction of these neural structures. Magnetic resonance imaging is the gold standard for evaluation of the spinal cord, nerve roots, and vertebral column in suspected cervical spondylotic myelopathy. Multiplanar visualization allows for evaluation of potential compressive pathology with specific localization.