Title: Neurological Recovery in Conservatively Managed Severe Cervical Spondylotic Myelopathy: Case Report
Author: Hemali J. Gandhi
DOI: https://dx.doi.org/10.18535/jmscr/v7i3.210
Abstract
Cervical spondylotic myelopathy is spinal cord compression due to pathophysiological narrowing of spinal canal causing ischemic and neuronal damage. Conservative approach in moderate to severe cervical spondylotic myelopathy is rare. We present a case study of a 51-year-old patient with complains of imbalance and weakness in bilateral lower limbs for 2 weeks along with difficulty in standing and walking. Magnetic Resonance Imaging revealed large posterior disc herniation compressing cervical spinal cord at level C5-C6 and ligamentum flavum hypertrophy with cord oedema. The patient underwent conservative treatment with subsequent resolution of symptoms. 2 years follow-up indicated no recurrence and complete resolution of clinical symptoms. This case report shows a possibility of conservative trial for moderate to severe cervical spondylotic myelopathy.
Keywords: Severe cervical spondylotic myelopathy, neurological recovery, conservative management.
References
- Gabriel Peixoto Lea˜o Almeida, Kysia Karine Almeida Carneiro, Ame´lia Pasqual Marques, Manual therapy and therapeutic exercise in patient with symptomatic cervical spondylotic myelopathy: A case report, Journal of Bodywork & Movement Therapies (2013) 17, 504e509.
- Wu JC1, Ko CC, et al, Epidemiology of cervical spondylotic myelopathy and its risk of causing spinal cord injury: a national cohort study. Neurosurg Focus. 2013 Jul;35(1):E10. Doi: 10.3171/2013.4.
- Elizabeth Sateren Zoller, Dominic Cannella,et al, Diagnosis and medical and surgical management of cervical spondylotic myelopathy, Journal of the American Academy of Physician Assistants , 2015.
- Kato S, Oshima Y, Oka H, et al. (2015) Comparison of the Japanese Orthopaedic Association (JOA) Score and Modified JOA (mJOA) Score for the Assessment of Cervical Myelopathy: A Multicenter Observational Study. PLoS ONE 10(4): e0123022. doi:10.1371/ journal. pone. 0123022.
- Fehlings MG, Wilson JR, et al. Efficacy and safety of surgical decompression in patients with cervical spondylotic myelopathy: results of the AO Spine North America prospective multi-center study. J Bone Joint Surg Am. 2013; 95:1651–8. doi: 10.2106/JBJS.L. 00589PMID:24048552.
- Kumbhar Kartik Revanappa, Vedantam Rajshekhar, Comparison of Nurick grading system and modified Japanese Orthopaedic Association scoring system in evaluation of patients with cervical spondylotic myelopathy, Eur Spine J (2011) 20:1545–1551 DOI 10.1007s00586-011-1773-y.
- Berg K, Wood-Douphinee S. et al, Measuring balance in the elderly, validation of an instrument. Can. J. Pub. Health(1992), July/Aug S7-11.
- Nee et al, Neural tissue management provides immediate clinically relevant benefits without harmful effects for patients with nerve related neck and arm pain: a randomised trial. Journal of Physiotherapy, 2012.
- Efstathia, M.A et al, Effectiveness of neural mobilisation in patients with spinal radiculopathy: A critical review. Journal of Bodywork and Movement Therapy, 2014.