• CSM is the leading cause of spinal cord injury in adults, often due to aging affecting cervical vertebrae.

• Studies show a male-to-female ratio of 2.7:1, with an average diagnosis age of 63.8 years, mostly affecting the C5/C6 level.

• Include trauma, axial weight bearing on neck/head, genetic predisposition, and smoking.

• Key factors include disc degeneration, subperiosteal bone formation, ossification of posterior longitudinal ligament, and hypertrophy of the ligamentum flavum, leading to spinal canal compression and narrowing.

• Symptoms include gait abnormalities, cervical spine stiffness, sharp arm pain, motor dysfunction, changes in sensation, loss of strength, reduced proprioception, toileting issues, and L’Hermitte’s Sign.

• The examination may use a test cluster including gait deviation, Hoffman’s test, inverted supinator sign, Babinski sign, and age over 45 to help in diagnosis.

• Primarily considered a surgical condition due to the progressive nature of impairments from nonoperative treatments. Studies support better outcomes with surgical intervention, particularly in cases of moderate-to-severe CSM.
• Management guidelines suggest surgery or a trial of structured rehabilitation for mild CSM, with a strong recommendation for surgery in moderate-to-severe cases. Regular clinical follow-up is advised for patients with cervical cord compression but no myelopathy.

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