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Making Sense of Cervical Myelopathy

In this study 54 patients with cervical myelopathy were matched with 54 healthy volunteers (control group) of the same age and gender. Myelopathy refers to any problem with the function of the spinal cord. Cervical is the location in the neck or upper part of the spine.

The patients had myelopathy from a protruding disc putting pressure on the spinal cord. Messages about the body, joints, and muscles go to the brain through the spinal cord. Sensations of where these body parts are at any point in time called proprioception are sent to the brain via the spinal cord. There are two kinds of proprioception. One refers to the position of a joint. The other has to do with movement: how fast, how much, and in what direction the joint is moving.

Knee proprioception was measured for both groups. The researchers wanted to see if position sense of the knee joint shows how severe cervical myelopathy is. The test is easy to do.

Measuring proprioception is done by placing the joint at a specific angle for several seconds. The first position was at 30 degrees. Then the knee was returned to its resting position. The baseline or resting position was with patient or subject sitting and the knee bent 90 degrees. Each person was asked to return the knee to the 30 degree angle of flexion. The test was repeated with the knee at 60 degrees.

The myelopathy group had much higher errors than the control group. The authors report that the present study shows proprioception is impaired in cervical myelopathy. They weren't able to conclude that knee proprioception can be used as a measure of the degree of spinal cord involvement.

References: Hiroyuki Takayama, MD, et al. Impaired Joint Proprioception in Patients with Cervical Myelopathy. In Spine. January 1, 2005. Vol. 30. No. 1. pp. 83-86.

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