Cervical myelopathy: clinical and neurophysiological evaluation

Area of Science:

• Orthopedics
• Neurology
• Epidemiology

Background:

• Neck pain is common, affecting 34% of the population, with higher prevalence and longer duration in women and older individuals.
• Chronic neck pain (lasting >6 months) affects approximately 14% of the general population.
• Age-related degenerative changes in the cervical spine are implicated in neck pain and may lead to cervical myelopathy.

Purpose of the Study:

• To investigate the prevalence and characteristics of neck pain.
• To explore the relationship between cervical spine changes, neck pain, and cervical myelopathy.
• To highlight the role of neurophysiological assessments in diagnosing related syndromes.

Main Methods:

• Epidemiological data analysis to determine the prevalence of neck pain and chronic neck pain.
• Review of literature on morphologic changes in the cervical spine and their association with pain and myelopathy.
• Discussion of neurophysiological assessment methods, including Electromyography (EMG), Sensory Evoked Potentials (SEPs), and Motor Evoked Potentials (MEPs) for diagnosing nerve root compression and cervical myelopathy.

Main Results:

• Overall neck pain frequency is 34%, with increased duration in women and with age.
• Chronic neck pain affects 14% of the population.
• Cervical myelopathy incidence and prevalence remain unknown, but structural changes may contribute to its development.

Conclusions:

• Neck pain is a significant public health issue, particularly in women and the elderly.
• Degenerative cervical spine changes are crucial in the pathogenesis of neck pain and potentially cervical myelopathy.
• Neurophysiological tests like EMG, SEPs, and MEPs are valuable adjuncts for diagnosing radicular and myelopathic syndromes.