Focus On Cervical Myelopathy

Cervical myelopathy is a condition caused by narrowing of the spinal canal leading to cord dysfunction.1 The most common causes are congenital stenosis and degenerative stenosis caused by spondylosis (degenerative osteoarthritis).2 When it is caused by spondylosis it is commonly referred to as cervical spondylotic myelopathy (CSM). Rheumatoid arthritis (RA) is a common condition affecting around 1% of the population. Around 90% of patients with RA have cervical spine involvement with between 11% and 58% of these patients having neurological involvement.3,4 Many of these patients have cervical myelopathy. Whatever the underlying disease process, the compression is usually progressive and will often require surgical intervention to prevent further disability. Many patients experience significant improvement in symptoms after surgery, so operative intervention should be considered for almost all patients.