The Essence of Clinical Practice Guidelines for Cervical Spondylotic Myelopathy, 2020

Cervical spondylotic myelopathy (CSM) is a general term for a disease-causing paralysis owing to spinal cord compression due to cervical spinal canal narrowing and age-related changes in the cervical spine combined with instability and trauma. CommentaryCSM is defined as follows.Symptoms When any of the following are observed.・Numbness in the four limbs (including the bilateral upper limbs only).・Manual dexterity impairment (such as difficulty using chopsticks and fastening buttons).・Gait impairment (such as trotting and difficulty descending stairs).・Bladder disturbance (such as frequent urination and urinary incontinence).Signs ・Reduced deep tendon reflex of the upper limbs at the level of impairment.・Accentuated tendon reflex below the level of impairment, the appearance of a pathological reflex, and myelopathic hand. Image Diagnosis・ On plain X-ray imaging, observation of intervertebral narrowing, posterior vertebral spur, and developmental spinal canal stenosis.・Findings of spinal cord compression on magnetic resonance imaging (MRI), computed tomography (CT), or myelography at the site of the lesion on plain X-ray imaging. Epidemiology SummaryCSM is common in men aged 50 years and older.It has been reported that the incidence of patients