Cervical Myelopathy – a Diagnostic Problem
Authors:
Z. Kadaňka 1; Y. Benešová 1; M. Mechl 2
Authors‘ workplace:
Neurologická klinika LF MU a FN Brno, 2Radiodiagnostická klinika LF MU a FN Brno
1
Published in:
Cesk Slov Neurol N 2009; 72/105(2): 110-114
Category:
Review Article
Overview
The article deals with the difficulties in diagnosis and treatment of cervical myelopathy. The author puts particular emphasis on the detection of compressive spondylotic myelopathy and its differential diagnosis and points out the risks of under- and overdiagnosis. A further large group of cervical myelopathies is represented by spinal tumours, the diagnosis and treatment of which involve many pitfalls. Amyotrophic lateral sclerosis is also associated with diagnostic problems because it may easily be mistaken for spondylotic cervical myelopathy for the ubiquity of degenerative changes of the spine, which leads to unnecessary operations. Many problems are related to acute transverse myelitis, because this term has often been used in a multivalent manner in relevant literature; its etiology is ambiguous and its recognition is therefore difficult.
Key words:
myelopathy – acute transverse myelitis – amyotrophic lateral sclerosis – motor neuron disease – multifocal motor neuropathy
Sources
1. Wilkinson M. The morbid anatomy of cervical spondylosis and myelopathy. Brain 1960; 83: 589– 617.
2. Montgomery DM, Brower RS. Cervical spondylotic myelopathy. Clinical syndrome and natural history. Orthop Clin North Am 1992; 23(3): 487– 493.
3. Mo ore AP, Blumhardt LD. A prospective survey of the ca use of non‑tra umatic spastic paraparesis and tetraparesis in 585 pati ents. Spinal Cord 1997; 35(6): 361– 367.
4. Clinton AG, Stevens JM, White ar P, Kendall Be. Identifi able ca use for po or o utcome in surgery for cervical spondylosis. Postoperative computed myelography and MR imaging. Ne uroradi ology 1990; 32: 450– 455.
5. Bonek R, Orlicka K, Macijek Z. Demyelinating lesi ons in the cervical cord in multiplex sclerosis 10 ye ars after onset of the dise ase. Correlati on between MRI parameters and clinical co urse. Ne urol Ne urochir Pol 2007; 41(3): 229– 233.
6. Selvi aridis P, Zo untsas B, Chatzisotiri o u A, Zarabo ukas T,Gerdemeli A. Demyelinitating plaque imitates an intramedullary tumo ur. Clin Ne urol Ne urosurg 2007; 109(10): 905– 909.
7. White JB, Miller GM, Layton KF, Kra uss WE. Nonenhancing tumors of the spinal cord. J Ne urosurg Spine 2007; 7(4): 403– 407.
8. Baek WS, Desai NP. ALS: pitfalls in the di agnosis. Pract Ne urol 2007; 7(2): 74– 81.
9. Matsunaga K, Iwamoto M, Tsuji S, Hashimoto T, Murai Y. The di agnosis of amyotrophic lateral sclerosis supported by motor evoked potenti als and MTI studi es. Rhinsho Singeigaku 1997; 37(3): 233– 238.
10. Hader WJ, Rpzdilsky B, Nair CP. The concurrence of multiplex sclerosis and amyotrophic lateral sclerosis. Can J Ne urol Sci 1986; 13(1): 66– 69.
11. Zevgaridis D, Medele RJ, Hamburger C, Steiger HJ, Re ulen HJ. Caverno us hemangi omas of the spinal cord. A revi ew of 117 cases. Acta Ne urochir (Wi en) 1999; 141(3): 237– 245.
12. Kharkar S, Shuck J, Conway J, Rigamonti D. The natural history of conservatively managed symptomatic intramedullary spinal cord cavernomas. Ne urosurgery 2007; 60(5): 865– 872.
13. Spetzger U, Gilsbach JM, Bertalanffy H. Caverno us angi omas of the spinal cord clinical presentati on, surgical strategy, and postoperative results. Acta Ne urochir (Wi en) 1995; 134(3– 4): 200– 206.
14. Matsuo K, Kakita A, Ishizu N, Endo K, Watanabe Y, MoritaT et al. Veno us congestive myelopathy: three a utopsy cases showing a vari ety of clinicopathologic fe atures. Ne uropatology 2008; 28(3): 303– 308.
15. Waziri A, Vonsattel JP, Kaiser MG, Anderson RC. Expansile, enhancing cervical cord lesi on with an associ ated syrinx secondary to demyelinati on. Case report and revi ew of the literature. J Ne urosurg Spine 2007; 6(1): 52– 56.
16. Harzheim M, Schlegel U, Urbach H, Klockgether T, Schmidt S. Discriminatory fe atures of acute transverse myelitis: a retrospective analysis of 45 pati ents. J Ne urol Sci 2004; 217(2): 217– 223.
17. Ino ue J, Ueno Y, Kogure T, Nagasaki F, Kimura O, Obara N et al. Analysis of the full- length genome of hepatitis B virus in the serum and cerebrospinal fluid of a patent with acute hepatitis B and transverse myelitis. J Clin Virol 2008; 41(4): 301– 304.
18. Sellner J, Lüthi N, Bühler R, Gebhardt A, Findling O, Greeve I et al. Acute parti al transverse myelitis: risk factors for conversi on to multiple sclerosis. Eur J Ne urol 2008; 15(4): 398– 405.
19. Sahni V, Garg D, Garg S, Agarwal SK, Singh NP. Unusu al complicati ons of hero ine abuse: Transverse myelitis, rhabdomyolysis, compartment syndrome, and ARF. Clin Toxicol (Phila) 2008; 46(2): 153– 155.
20. Yonenobu K, Okada K, Fujiwara K, Yamashita K, Ono K.Ca uses of ne urologic deteri orati on following surgical tre atment of cervical myelopathy. Spine 1986; 11(8): 818– 823.
21. Benzel EC, Lancon J, Kesterson L, Hadden T. Cervical laminectomy and dentate ligament secti on for cervical spondylotic myelopathy. J Spin Disord 1991; 4(3): 286– 295.
Labels
Paediatric neurology Neurosurgery NeurologyArticle was published in
Czech and Slovak Neurology and Neurosurgery
2009 Issue 2
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