Many of the respiratory, urinary, and skin infections that were traditionally treated in the hospital setting are now managed with home-based care or in a skilled nursing facility. One of the most widely used medications for this purpose is intravenou
Alabama Oct. 16: Advanced cardiac life support (ACLS) recertification course. Fairhope. (8 hrs: P) Sponsor: Thomas Hospital. Contact Cynthia Lober: 251-990-1685. Oct. 18-19: Advanced life support in obstetrics (ALSO). Birmingham. (17 h
Oct. 2-20: Transcultural health perspectives of Nepal, Bhutan, and Tibet. Asia. (24 hrs: P) Sponsor: Professional Education Society. Contact Nancy McCray, R.N.: 800-872-3070. Oct. 3-13: International family medicine: Poland/Czech Republic. Pol
Oct. 3-11: 2002 seminar in medicolegal issues. New England/Canada. (18 hrs: P) Sponsor: State Uni versity of New York at Stony Brook. Contact Dorothy Lane, M.D.: 631-444-2094. Oct. 7-18: 2002 seminar in medicolegal issues. East Mediterranean.
Jun. 18-21, 2003: WONCA region Europe ESGP/ FM-regional conference. Ljubljana, Slovenia. Sponsor: Slovenian Medical Association, Slovenian Family Medicine Society. Contact Igor Svab, M.D., Institute of Public Health, Trubarjeva 2, 1000 Ljubljana, Slov
Oct. 16-20, 2002: San Diego. Oct. 1-5, 2003: New Orleans. Oct. 13-17, 2004: Orlando. Sep. 28-Oct. 2, 2005: San Francisco.COPYRIGHT 2002 American Academy of Family PhysiciansCOPYRIGHT 2002 Gale Group
Clinical Quiz questions are based on selected articles in this issue. Answers appear in this issue. American Family Physician has been approved by the American Academy of Family Physicians as having educational content acceptable for Prescribe
The American Heart Association (AHA) has updated its recommendations for cardiovascular disease prevention. "AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update" appear in the July 15 issue of Circulation. T
The American College of Occupational and Environmental Medicine (ACOEM) has issued guidelines for dealing with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in the workplace. The recommendations appear in the June 20
The Committee on Obstetric Practice of the American College of Obstetricians and Gynecologists (ACOG) has issued an opinion paper on induction of labor for vaginal birth after cesarean (VBAC) delivery. ACOG Committee Opinion No. 271 appears in the Apr
Date: Sept 1, 2000
What is cervical spondylotic myelopathy?
Cervical spondylotic myelopathy (CSM) is a compression of the spinal cord in the neck. CSM often affects older adults. In people with CSM, changes in the bones, discs and ligaments of the spine cause pressure on the spinal cord. Some changes are because of normal aging. Some changes are caused by arthritis of the spine. CSM is the most common spinal cord problem in people 55 years and older in the United States. If CSM is not treated, it will usually stay the same or get worse. There's no way to tell ahead of time if it will get worse or not.
What are the symptoms of CSM?
CSM develops very slowly. Some symptoms of CSM may include neck stiffness, arm pain, numbness in the hands, and weakness of the arms and legs. A person with CSM may have stiff legs. CSM may make it difficult for a person to use his or her hands or to walk steadily. Other conditions, such as multiple sclerosis, amyotrophic lateral sclerosis and tumors on the spinal cord, can cause similar symptoms.
How is CSM diagnosed?
Your doctor will do a physical exam to see if you have CSM. He or she will look for changes in your strength, reflexes and ability to feel things. A magnetic resonance imaging (MRI) scan can confirm that you have spinal cord compression in your neck. The MRI can also show other problems that have similar symptoms to CSM, like tumors. If your doctor's not sure that you have CSM, he or she can do other tests. Your doctor may also want you to see a neurologist.
How is CSM treated?
Mild cases of CSM can be treated with neck braces or neck traction, but it's not clear if these treatments help in the long run. Surgery to reduce the compression of the spinal cord may help. Unfortunately, surgery doesn't help everyone. There are medicines that can relieve pain caused by CSM, but they don't help the underlying causes of CSM or relieve other symptoms like weakness or numbness.
COPYRIGHT 2000 American Academy of Family PhysiciansCOPYRIGHT 2000 Gale Group