Document Detail


Cervical spondylotic myelopathy in the young adult: A review of the literature and clinical diagnostic criteria in an uncommon demographic.
MedLine Citation:
PMID:  24731579     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Cervical spondylotic myelopathy (CSM) is typically encountered in the elderly population. Significant inconsistencies currently exist regarding the definition of the disorder, the true incidence of CSM in younger populations, and the established diagnostic criteria.
OBJECTIVE: To highlight the lack of standardization in the definition and diagnosis of CSM.
METHODS: A PubMed literature search was conducted spanning the years 2001-2011. The search was limited by the following terms: (1) English language, (2) adults (19-44 years old), and (3) "cervical spondylotic myelopathy." Each article was reviewed to determine if the presence of the definition of CSM existed in the article. The clinical characteristics used to make the diagnosis of CSM were recorded for each article. Cochran's Q statistic was used to determine whether some clinical characteristics were more frequently used than others.
RESULTS: Ninety-three papers were reviewed in detail and 16 case reports, reviews, and articles concerning less than 3 patients were excluded, resulting in 77 articles in the final analysis. The most common clinical definitions were gait disturbance (22/77 articles (28.6%)), upper limb paresthesias or sensory disturbance (21/77 (27.3%)), and clumsy hands (15/77 (19.5%)). Hyperreflexia, spasticity, and pathologically increased reflexes were identified as diagnostic criteria in a minority of patients.
CONCLUSION: The literature employs a wide range of neurologic signs and symptoms to make the diagnosis of CSM, with a majority of studies failing to rely on strict diagnostic criteria. The clinician should not discount CSM as an explanation for the aforementioned findings, as it is well-reported in the literature among the ages 18-44.
Authors:
Peter S Amenta; George M Ghobrial; Kelly Krespan; Phi Nguyen; Muhammed Ali; James S Harrop
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Publication Detail:
Type:  REVIEW     Date:  2014-3-2
Journal Detail:
Title:  Clinical neurology and neurosurgery     Volume:  120C     ISSN:  1872-6968     ISO Abbreviation:  Clin Neurol Neurosurg     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-4-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7502039     Medline TA:  Clin Neurol Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  68-72     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier B.V. All rights reserved.
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