title: The contribution of neurophysiology in the diagnosis and management of cervical spondylotic myelopathy: a review.
abstract: METHODS
  Topical review of the literature.
  
  
  OBJECTIVE
  The objective of this review article was to assess indications and usefulness of various neurophysiological techniques in diagnosis and management of cervical spondylogenic myelopathy (CSM).
  
  
  METHODS
  The MEDLINE, accessed by Pubmed and EMBASE electronic databases, was searched using the medical subject headings: 'compressive myelopathy', 'cervical spondylotic myelopathy (CSM)', 'cervical spondylogenic myelopathy', 'motor evoked potentials (MEPs)', 'transcranial magnetic stimulation', 'somatosensory evoked potentials (SEPs)', 'electromyography (EMG)', 'nerve conduction studies (NCS)' and 'cutaneous silent period (CSP)'.
  
  
  RESULTS
  SEPs and MEPs recording can usefully supplement clinical examination and neuroimaging findings in assessing the spinal cord injury level and severity. Segmental cervical cord dysfunction can be revealed by an abnormal spinal N13 response, whereas the P14 potential is a reliable marker of dorsal column impairment. MEPs may also help in the differential diagnosis between spinal cord compression and neurodegenerative disorders. SEPs and MEPs are also useful in follow-up evaluation of sensory and motor function during surgical treatment and rehabilitation. EMG and NCS improve the sensitivity of cervical radiculopathy detection and may help rule out peripheral nerve problems that can cause symptoms that are similar to those of CSM. CSP also shows a high sensitivity for detecting CSM.
  
  
  CONCLUSIONS
  Neuroimaging, especially magnetic resonance imaging, represents the procedure of choice for the diagnosis of CSM, but a correct interpretation of morphological findings can be achieved only if they are correlated with functional data. The studies reported in this review highlight the crucial role of the electrophysiological studies in diagnosis and management of CSM.
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.|Department of Neurology, Franz Tappeiner Hospital, Merano, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Nardone
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Y
authors.initials: Y
authors.lastname: Höller
authors.affiliation: Department of Neurology, Franz Tappeiner Hospital, Merano, Italy.|Department of Neurological, and Movement Sciences, Section of Clinical Neurology, University of Verona, Verona, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Brigo
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.|Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria.
authors.forename: V N
authors.initials: VN
authors.lastname: Frey
authors.affiliation: Department of Neurology, Franz Tappeiner Hospital, Merano, Italy.
authors.forename: P
authors.identifier: http://orcid.org/0000-0002-2101-6066
authors.initials: P
authors.lastname: Lochner
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
authors.forename: S
authors.initials: S
authors.lastname: Leis
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
authors.forename: S
authors.initials: S
authors.lastname: Golaszewski
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.|Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Trinka
mesh_terms: D000818:Animals; D019468:Disease Management; D004576:Electromyography; D005071:Evoked Potentials / Q000502:physiology; D006801:Humans; D009431:Neural Conduction / Q000502:physiology; D009482:Neurophysiology / Q000639:trends; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D055009:Spondylosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy