WordNet

relating to or associated with the neck
of or relating to the cervix of the uterus; "cervical cancer"

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(子宮などの)頚(けい)部の(にできた)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/01/08 23:55:07」(JST)

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Myelopathy refers to pathology of the spinal cord.^[1] When due to trauma, it is known as spinal cord injury. When inflammatory, it is known as myelitis. Disease that is vascular in nature is known as vascular myelopathy.

Clinical signs and symptoms depend on which spinal cord level (cervical, thoracic or lumbar) is affected and the extent (anterior, posterior or lateral) of the pathology, and may include:

upper motor neuron signs (weakness, spasticity, clumsiness, altered tonus)
pathological hyperreflexia and inverted Plantar reflex (positive Babinski sign)
sensory deficits
bowel/bladder symptoms and sexual dysfunction.

Differential diagnosis of chronic myelopathy is extensive.^[2]

The presence and severity of myelopathy can be evaluated by means of Transcranial Magnetic Stimulation (TMS), a neurophysiological method that allows the measurement of the time required for a neural impulse to cross the pyramidal tracts, starting from the cerebral cortex and ending at the anterior horn cells of the cervical, thoracic or lumbar spinal cord. This measurement is called Central Conduction Time (CCT). TMS can aid physicians to:^[3]

determine whether myelopathy exists
identify the level of the spinal cord where myelopathy is located. This is especially useful in cases where more than two lesions may be responsible for the clinical symptoms and signs, such as in patients with two or more cervical disc hernias^[4]
follow-up the progression of myelopathy in time, for example before and after cervical spine surgery

TMS can also help in the differential diagnosis of different causes of pyramidal tract damage.^[5]

References[edit]

^ "myelopathy" at Dorland's Medical Dictionary
^ Myelopathy differential diagnosis web site
^ Chen R, Cros D, Curra A, Di Lazzaro V, Lefaucheur JP, Magistris MR, Mills K, Rösler KM, Triggs WJ, Ugawa Y, Ziemann U. The clinical diagnostic utility of transcranial magnetic stimulation: report of an IFCN committee. Clin Neurophysiol. 2008 Mar;119(3):504-32.
^ Deftereos SN, et al. (April–June 2009). "Localisation of cervical spinal cord compression by TMS and MRI". Funct Neurol 24 (2): 99–105. PMID 19775538. Cite uses deprecated parameters (help)
^ Chen R, Cros D, Curra A, et al. (March 2008). "The clinical diagnostic utility of transcranial magnetic stimulation: report of an IFCN committee". Clin Neurophysiol 119 (3): 504–32. doi:10.1016/j.clinph.2007.10.014. PMID 18063409. Cite uses deprecated parameters (help)

UpToDate Contents

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1. 頚椎症性脊髄症 cervical spondylotic myelopathy
2. 頸部神経根障害の臨床的特徴および診断 clinical features and diagnosis of cervical radiculopathy
3. 頚部痛および頚椎症の患者の評価 evaluation of the patient with neck pain and cervical spine disorders
4. 頸部神経根障害の治療 treatment of cervical radiculopathy
5. 関節リウマチの神経学的症状 neurologic manifestations of rheumatoid arthritis

English Journal

Hirayama disease.

Foster E1, Tsang BK2, Kam A3, Storey E2, Day B4, Hill A2.
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia.J Clin Neurosci.2015 Jun;22(6):951-954. doi: 10.1016/j.jocn.2014.11.025. Epub 2015 Mar 9.
This article discusses three patients with likely Hirayama disease. They have no other significant past medical history and no personal or family history of other neurological disorders. Hirayama disease is a form of cervical myelopathy attributed to forward displacement of the posterior cervical du
PMID 25766368

Dorsal laminectomy for treatment of cervical vertebral stenotic myelopathy in an alpaca.

Barker WH1, Witte TH, Driver CJ, Jull P, Whitehead CE, Volk HA.
Journal of the American Veterinary Medical Association.J Am Vet Med Assoc.2015 May 15;246(10):1122-8. doi: 10.2460/javma.246.10.1122.
Case Description-An 11-year-old male breeding alpaca was evaluated for a 2-day history of lowered head carriage and lethargy. Clinical Findings-On initial examination, the alpaca had signs of lethargy and lowered carriage of the head and neck, but no specific neurologic deficits. Medical management
PMID 25932939

Long-term Outcomes of the US FDA IDE Prospective, Randomized Controlled Clinical Trial Comparing PCM Cervical Disc Arthroplasty With Anterior Cervical Discectomy and Fusion.

Phillips FM1, Geisler FH, Gilder KM, Reah C, Howell KM, McAfee PC.
Spine.Spine (Phila Pa 1976).2015 May 15;40(10):674-83. doi: 10.1097/BRS.0000000000000869.
STUDY DESIGN: Prospective, multicenter, randomized clinical trial.OBJECTIVE: To evaluate the long-term safety and effectiveness of the PCM Cervical Disc compared with anterior cervical discectomy and fusion (ACDF) in treatment of patients with symptomatic single-level degenerative spondylosis betwee
PMID 25955086

Japanese Journal

Cervical flexion myelopathy in a patient showing apparent long tract signs: A severe form of Hirayama disease

Sakai Kenji,Ono Kenjiro,Okamoto Yoshiyuki,Murakami Hideki,Yamada Masahito
Joint Bone Spine 78(3), 316-318, 2011-05
… We describe an 18-year-old male with cervical flexion myelopathy with Hirayama disease-like features who showed apparent long tract signs. … Cervical magnetic resonance images and computed tomographic myelography revealed anterior displacement with compression of the cervical cord in flexion that was more apparent in the right side. … The right side of the cervical cord showed severe atrophy. …
NAID 120002772028