Many chiropractic patients have cervical spine pathology and/or peripheral neuromusculoskeletal complaints, and cervical degenerative disease is likely to be increasingly common in chiropractic patient’s.
Cervical degenerative disease with spondylotic changes may evolve into conditions that compress the spinal cord and/or nerve roots. Spinal cord compression in the cervical region of one or more levels with symptom manifestation may be referred to as cervical compressive myelopathy (CCM) or cervical spondylotic myelopathy (CSM).
Radicular symptoms can result from involvement of the nerve roots from degenerative cervical changes. Myelopathy with cord compression may occur separately or at the same time as nerve root involvement. If so, the condition is called radiculomyelopathy.1-3
It’s important to monitor the neurological status of patients who may progress from radicular to myelopathy symptoms. Then, refer the patient as appropriate when neurological findings progress. As these conditions may be age related, you may notice a slow, intermittent progression. It may be very gradual but will commonly have very distinct findings. Adverse changes may be noted in sensory, motor and autonomic nervous system function.
CCM/CSM is the most common myelopathy, which can be caused by the narrowing of the spinal canal from stenosis, spondylosis, ossification of the posterior longitudinal ligament, intervertebral disc herniation or tumors. As a result of the cord compression, intraspinal cord pressure increases, which can lead to patients presenting with various symptoms.
Symptoms
Some patients will report neck pain, upper and lower extremity paresthesia, muscle weakness or spasticity, altered gait patterns with imbalance, lower extremity stiffness and jerking, upper and/or lower extremity sensory loss, clumsiness including fine motor skills, bowel, bladder, and sexual dysfunction.4,5 These symptoms can be caused by problems in the sensory, motor and the autonomic nervous systems.6
Symptoms typically present after age 40 and most commonly between 50 and 70. Onset is typically insidious but may be associated with trauma. Men are more frequently afflicted than women by a ratio of 3:2. 7
Yours In Health,
West Los Angeles Chiropractic ®
310-914-9400
https://www.WestLosAngelesChiropractic.com
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