Angiography is used to examine blood vessels in suspected cases of vascular myelopathy. Further imaging modalities used for evaluating myelopathy include plain X-rays for detecting arthritic changes of the bones, and Computer Tomography, which is often used for pre-operative planning of surgical interventions for cervical spondylotic myelopathy. Apart from T1 and T2 MRI images, which are commonly used for routine diagnosis, more recently researchers are exploring quantitative MRI signals. The best way to visualize the spinal cord is magnetic resonance imaging (MRI). Most commonly this involves medical imaging. Once the clinical diagnosis myelopathy is established, the underlying cause must be investigated. As the disease is thought to be progressive, this may impact negatively on outcome. ![]() As a consequence, the diagnosis of CSM is often delayed. In some cases the onset of myelopathy is rapid, in others, such as CSM, the course may be insidious with symptoms developing slowly over a period of months. Because the term myelopathy describes a clinical syndrome that can be caused by many pathologies the differential diagnosis of myelopathy is extensive. Myelopathy is primarily diagnosed by clinical exam findings. Bowel/bladder symptoms and sexual dysfunctionĭiagnosis Diagnosis of myelopathy. ![]() Lower motor neuron signs-weakness, clumsiness in the muscle group innervated at the level of spinal cord compromise, muscle atrophy, hyporeflexia, muscle hypotonicity or flaccidity, fasciculations.Upper motor neuron signs-weakness, spasticity, clumsiness, altered tonus, hyperreflexia and pathological reflexes, including Hoffmann's sign and inverted plantar reflex (positive Babinski sign).Presentation Ĭlinical signs and symptoms depend on which spinal cord level (cervical, thoracic, or lumbar) is affected and the extent (anterior, posterior, or lateral) of the pathology, and may include: ![]() In Asian populations, spinal cord compression often occurs due to a different, inflammatory process affecting the posterior longitudinal ligament. Disease that is vascular in nature is known as vascular myelopathy. When inflammatory, it is known as myelitis. When due to trauma, myelopathy is known as (acute) spinal cord injury. The most common form of myelopathy in humans, cervical spondylotic myelopathy (CSM), also called degenerative cervical myelopathy, results from narrowing of the spinal canal ( spinal stenosis) ultimately causing compression of the spinal cord. Myelopathy describes any neurologic deficit related to the spinal cord.
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