Differential diagnosis of spondylotic myelopathy

• approximately 12% of patients with myelopathic features attributed to a degenerative spondylosis actually have a different underlying problem
  • intra-spinal tumours, syringomyelia, and Arnold–Chiari malformations may all mimic spondylotic myelopathy
  • amyotrophic lateral sclerosis and multiple sclerosis are also in the differential
  • cervical spine involvement in rheumatoid arthritis may cause cervical instability, and thus myelopathy
    • however this is a feature of chronic rheumatoid disease, which should thus be obvious from the history and examination

Reference:

1. ARC (January 2002). Rheumatic Disease in Practice