[Skip to Content]
[Skip to Content Landing]
July 11, 1977

Hemiparesis and Cervical Spondylosis-Reply

JAMA. 1977;238(2):127. doi:10.1001/jama.1977.03280020030008

The precise cause of the myelopathy associated with cervical spondylosis is not known. Protruded discs, osteophyte formation, spinal canal narrowing, and zygapophyseal joint degeneration have all been pathologically described in cervical spondylosis, yet the relative roles of each of these findings in the production of clinical signs is unknown in the majority of cases.1 Since the basic pathophysiologic process is in doubt, it is therefore difficult to explain how either one or a combination of degenerative changes could unilaterally affect the corticospinal tract in the cervical cord. We did not intend to suggest that paramedian disc protrusion was the sole cause of the myelopathy but rather that this may have been a contributing factor because of the striking unilateral nature of the signs.

In addition to narrowed intervertebral spaces, the roentgenograms in case 1 were felt to show substantial sclerotic changes of the vertebral margins as well