Abstract:
:This section of the cervical spondylotic myelopathy (CSM) Spine focus issue collates evidence related to diagnosis, outcome assessment, and genetics. Given that a variety of different disease states can present similarly, a guide for diagnosing and differentiating CSM from other neurological conditions is initially presented. Although the value of magnetic resonance imaging in diagnosing CSM is cemented, its value as a tool to predict future outcome is less well established. To this end, the existing evidence suggests that although increased T2 cord signal is of limited value, the pairing of high T2 signal with low T1 signal, or a high T2 to T1 signal ratio, is associated with a reduced potential for neurological recovery at follow-up. Outcome assessment in CSM is of paramount importance when monitoring patients' clinical course or measuring the efficacy of therapeutic interventions. Here, the main outcome measures that have been used to assess patients with CSM are reviewed. At present, we recommend that clinicians acquire the modified Japanese Orthopaedic Association scale score and the Neck Disability Index on all patients with CSM at presentation and follow-up. Finally, in regard to genetics, the existing evidence seems to support the principle of an inherited predisposition to both CSM and ossification of the posterior longitudinal ligament. Although several genetic polymorphisms have been consistently associated with ossification of the posterior longitudinal ligament, no specific polymorphisms were consistently associated with CSM.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Wilson JR,Fehlings MG,Kalsi-Ryan S,Shamji MF,Tetreault LA,Rhee JM,Chapman JRdoi
10.1097/BRS.0b013e3182a7f4bfsubject
Has Abstractpub_date
2013-10-15 00:00:00pages
S76-7issue
22 Suppl 1eissn
0362-2436issn
1528-1159journal_volume
38pub_type
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