CHAPTER 4
CERVICAL SPODYLOTIC
MYELOPATHY
What is it?
The spine consists of a series of vertebrae that are stacked on top of one
another from the neck to the pelvis. These vertebrae are connected and kept
in the correct position by the discs that are between the vertebrae and also the
facet joints that are located on the side of the vertebral bodies which interlock
with one another (see the chapter Anatomy of the Spine).
There are also supporting ligaments and tendons. The discs between the two
adjacent vertebrae are composed of a central, soft, jelly-like substance called
the nucleus pulposus and an outer, tougher fibrous part called the annulus
fibrosus.These discs also act as shock-absorbers and maintain height between
the vertebrae. As we age the nucleus dehydrates and the height between the
vertebrae diminishes. The body’s response to this is the formation of bony
ridges on the edge of the vertebrae, called osteophytes. These bony ridges
(bone spurs) can cause compression of nerve roots and in the case of cervical
spondylotic myelopathy, the spinal cord itself.
In other cases the tough annulus fibrosus of the disc may tear, leaving a defect
in the strong outer layer. A bit of the nucleus pulposus can then push through
this tear and end up in the spinal canal and press against the nerves in the
spinal canal. This can be caused by a traumatic i