The assessment of cervical myelopathy

The assessment of cervical myelopathy can be challenging, especially early in the course of the disease. Typical symptoms, including pain, neck stiffness, paresthesias, weakness, clumsiness, disequilibrium, difficulty with bladder control and functional deficits, and signs, including decreased cervical range of motion, sensory abnormalities, weakness, spasticity, and gait disturbance, become more obvious as the disease progresses. Disease specific functional assessments can aid in the diagnosis. A detailed clinical assessment should always be interpreted in conjunction with supplemental assessment tools, including imaging and electrodiagnostic studies. This article will review typical clinical findings, the differential diagnosis, and the utilization of supplemental assessment tools for the evaluation of cervical myelopathy.