Spondylomyelopathy Causing Cord Atrophy
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Well, I said that I lied to you twice early on
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in this presentation, but actually,
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now I'm going to tell you I've lied to you three times.
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Here is an example of a patient who has
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degenerative disease at the C3 and C4 level.
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And you can see that there is severe spinal
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stenosis at C3-C4 and C4-C5, associated with a
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focal area of cord signal abnormality
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opposite the C4-C5 level.
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Now, I told you that the CSF space will expand when you
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have cord atrophy. Well, that's true in general.
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However, if you have spinal stenosis,
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you notice that the canal gets narrowed
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and therefore you will not see the
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CSF expansion when you have spinal stenosis.
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Here's the axial scan.
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You note that the culprit here is something called
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OPLL, Ossification of the Posterior Longitudinal Ligament,
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which is compressing the spinal cord,
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which has abnormal cord signal.
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However, we don't have expansion of the CSF space
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around the narrowed canal because it's narrowed
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and there is no location or place for the CSF to expand to.
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So this is an example again of spondylomyelopathy
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injury to the spinal cord due to spondylosis
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degenerative disease, associated with cord atrophy,
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but no expansion of the CSF space
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because of that spinal stenosis,
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which is demonstrated quite nicely
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at the C3-C4 and C4-C5 level.
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
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