Spondylotic cervical myelopathy

Cervical spondylosis is the most common cause of cervical myelopathy.

Degenerative changes in the cervical spine which can cause narrowing of the spinal canal include:

• osteophytes from the posterior vertebral bodies
• thickening of the ligamentum flavum and the posterior longitudinal ligament
• prolapse of an intervertebral disc

The resulting myelopathy causes spastic weakness of the legs and in more advanced cases there may be sphincter disturbance and sensory ataxia of the lower limbs.

There is usually associated osteophyte formation at the intervertebral facet joints which may damage emerging nerve roots. The result is often lower motor neurone weakness and numbness of the upper limbs.