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Spondylotic and Other Structural Myelopathies
Continuum (Minneapolis, Minn.)
|February 1, 2021
Summary
This review discusses structural causes of myelopathy, including common spondylotic disease and rarer treatable conditions. Accurate diagnosis through history, examination, and imaging guides treatment decisions for spinal cord compression.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Myelopathy, a spinal cord disorder, often stems from structural abnormalities.
- Advancements in neuroimaging reveal numerous spinal abnormalities in patients, even those with minimal symptoms.
Purpose of the Study:
- To review common and infrequent structural causes of myelopathy.
- To emphasize the importance of correlating clinical findings with imaging for treatment planning.
Main Methods:
- Literature review of recent clinical series and published data.
- Analysis of neuroimaging findings in relation to myelopathy.
Main Results:
- Common causes include spondylotic myelopathy.
- Infrequent but treatable causes identified: syringomyelia, spinal cord herniation, arachnoid cysts/bands/webs, epidural lipomatosis, Hirayama disease, and arachnoiditis.
- Improved understanding of the natural history and risks of intervention versus conservative management.
Conclusions:
- Structural causes are a frequent reason for neurologic consultation.
- A thorough correlation of patient history, neurological examination, and imaging is crucial for determining the optimal management strategy (intervention vs. conservative).
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