Cervical myelopathy is the most common cause of spinal cord dysfunction in adults over fifty-five, driven by chronic cervical cord compression. Master the clinical signs, MRI signal changesand surgical decision-making to halt progressive neurological decline. ⏱ Chapters 0:00 Intro 0:19 Essentials 0:58 Classification 1:38 Nurick 2:06 Mnemonics 2:33 Clinical Signs 3:05 Imaging Signs 3:33 Algorithm 4:10 Approach Selection 4:44 Numbers 5:14 Clinical reasoning — Manage 5:42 Clinical reasoning — Pearls This comprehensive orthopaedic masterclass covers everything you need to know about degenerative cervical myelopathy. We explore the underlying pathophysiology of spinal cord compression, break down the Nurick classification systemand detail how to differentiate upper motor neuron lesions from lower motor nerve root issues. From interpreting T2 hyperintensity on MRI to deciding between an anterior cervical discectomy fusion (ACDF) and a posterior laminoplasty, this video provides a structured framework for managing this progressive condition. 🦴 IN THIS VIDEO YOU'LL LEARN • How to identify progressive upper motor neuron signs such as hyperreflexia, Hoffman signand the inverted radial reflex • The pathophysiological mechanisms of cervical cord compression including direct mechanical compression, ischaemiaand repetitive microtrauma • How to apply the Nurick classification to grade functional impairment and guide surgical timing • Differentiating cervical myelopathy from radiculopathy and distinguishing upper motor neuron versus lower motor neuron lesions • Interpreting MRI signal changes, including T2 hyperintensity, T1 hypointensityand the prognostic implications of myelomalacia and the snake-eye sign • Using the VITAMINS mnemonic to structure your differential diagnosis and rule out structural mimics • Selecting the appropriate surgical approach based on anatomical compression patterns, such as ACDF for anterior pathology and posterior decompression for multilevel stenosis • Understanding why early surgical intervention at Nurick grades 1 and 2 yields significantly better clinical outcomes than delayed surgery ⏱️ CHAPTERS 📌 KEY TAKEAWAYS ✔️ Cervical myelopathy is a progressive disease; 80% of patients will deteriorate without surgical decompression. ✔️ T2 hyperintensity on MRI indicates cord oedema or gliosis and predicts a poorer functional recovery. ✔️ Surgical decompression halts progression and improves symptoms in roughly 70-80% of patients. ✔️ Anterior compression at one or two levels favours ACDF, while multilevel stenosis (more than three levels) typically requires a posterior approach. ✔️ Do not wait for severe disability: early intervention before chair-bound status is critical for preserving neurological function. 👩⚕️ WHO THIS IS FOR This masterclass is designed for orthopaedic trainees, medical students, junior doctorsand clinicians seeking a deep understanding of spinal cord compression, as well as curious patients wanting to learn about the diagnosis and surgical management of degenerative cervical myelopathy. 📚 RELATED TOPICS: Ossification of the posterior longitudinal ligament (OPLL) · Anterior Cervical Discectomy and Fusion (ACDF) surgical techniques · Cervical laminoplasty vs laminectomy outcomes · Differentiating myelopathy from amyotrophic lateral sclerosis (ALS) · Degenerative cervical radiculopathy and nerve root compression · The Pavlov ratio and congenital cervical stenosis 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #cervicalmyelopathy #orthopaedics #spinesurgery #spinalcordcompression #spondylosis #neurosurgery #medicine #medicalstudent #orthopaedicsurgery #spinestenosis #clinicalneurology #mri #surgery #doctor