Orthonotes
Orthonotes
by the.bonestories
v3.0 Fusion
v3.0 Fusion
spine topic hub

Cervical Spondylotic Myelopathy — Pathophysiology & Surgery

CSM is progressive spinal cord dysfunction due to degenerative stenosis (disc osteophyte complex, ligamentum flavum hypertrophy, OPLL). Symptoms: hand clumsiness, gait imbalance, Lhermitte sign; UMN signs below level (Hoffmann, Babinski) with possible segmental LMN at level. MRI is diagnostic; assess sagittal alignment, number of compressed levels, and canal diameter. Surgery for moderate–severe or progressive CSM: anterior (ACDF/corpectomy) vs posterior (laminoplasty/laminectomy + fusion) based on alignment and levels. Prognostic factors: shorter symptom duration, younger age, no signal change on T2 MRI.

Overview

Topic summary

View wiki
CSM is progressive spinal cord dysfunction due to degenerative stenosis (disc osteophyte complex, ligamentum flavum hypertrophy, OPLL). Symptoms: hand clumsiness, gait imbalance, Lhermitte sign; UMN signs below level (Hoffmann, Babinski) with possible segmental LMN at level. MRI is diagnostic; assess sagittal alignment, number of compressed levels, and canal diameter. Surgery for moderate–severe or progressive CSM: anterior (ACDF/corpectomy) vs posterior (laminoplasty/laminectomy + fusion) based on alignment and levels. Prognostic factors: shorter symptom duration, younger age, no signal change on T2 MRI.
MCQs

High-yield practice questions

Start topic quiz
Question 1

What is the primary pathophysiological mechanism leading to cervical spondylotic myelopathy (CSM)?

Question 2

Which of the following MRI findings is most indicative of cervical spondylotic myelopathy?

Question 3

What symptom is considered a classic feature of cervical spondylotic myelopathy?

Question 4

Which surgical approach is typically preferred for patients with moderate to severe cervical spondylotic myelopathy and significant anterior compression?

Question 5

What is the significance of the Torg-Pavlov ratio in cervical spondylotic myelopathy?

Question 6

Which of the following statements about Lhermitte's sign is true?

Question 7

What is the typical neurological presentation in cervical spondylotic myelopathy?

Question 8

Which of the following factors is associated with a better surgical prognosis in cervical spondylotic myelopathy?

Question 9

In which population is ossification of the posterior longitudinal ligament (OPLL) most prevalent?

Question 10

What is the most common presenting symptom of cervical spondylotic myelopathy?