Treatment of cervical myelopathy in patients with the fibromyalgia syndrome: outcomes and implications Some patients with fibromyalgia also exhibit the neurological signs of cervical myelopathy. We sought to determine if treatment of cervical myelopathy in patients with fibromyalgia improves the symptoms of fibromyalgia and the patients' quality of life. A non-randomized, prospective, case control study comparing the outcome of surgical (n = 40) versus non-surgical (n = 31) treatment of cervical myelopathy in patients with fibromyalgia was conducted. Outcomes were compared using SF-36, screening test for somatization, HADS, MMPI-2 scale 1 (Hypochondriasis), and self reported severity of symptoms 1 year after treatment. There was no significant difference in initial clinical presentation or demographic characteristics between the patients treated by surgical decompression and those treated by non-surgical means. There was a striking and statistically significant improvement in all symptoms attributed to the fibromyalgia syndrome in the surgical patients but not in the non-surgical patients at 1 year following the treatment of cervical myelopathy (P 0.01). There was a statistically significant improvement in the scores from Scale 1 of the MMPI-2 and the screening test for somatization disorder, and the anxiety and depression scores exclusively in the surgical patients (Wilcoxon signed rank, P 0.001). The surgical treatment of cervical myelopathy due to spinal cord or caudal brainstem compression in patients carrying the diagnosis of fibromyalgia can result in a significant improvement in a wide array of symptoms usually attributed to fibromyalgia with attendant measurable improvements in the quality of life. We recommend detailed neurological and neuroradiological evaluation of patients with fibromyalgia in order to exclude compressive cervical myelopathy, a potentially treatable condition https://www.upress.umn.edu/test-division/bibliography/2000-2009/2007/heffez_treatment_2007 https://www.upress.umn.edu/logo.png

D.S. Heffez, R.E. Ross, Y. Shade-Zeldow, K. Kostas, M. Morrissey, D.A. Elias, and A. Shepard (2007)

Treatment of cervical myelopathy in patients with the fibromyalgia syndrome: outcomes and implications

Eur.Spine J., 16(9):1423-1433.

Keywords

Acids
Amines
Analgesics
ANOVA
Anxiety
Anxiety and depression
Case-control studies
Cervical vertebrae
Clinical presentation
Control
Cyclohexanecarboxylic Acids
Decompression
Surgical
Demographic characteristics
Depression
Depression score
Diagnosis
Fisher's Exact Test
Gabapentin
Health Surveys
Hypochondriasis
IF
Mean
MMPI 2
MMPI-2
Neurosurgery
Patients
quality of life
Research
Scale 1
Score
Screening
Self
Severity
Somatization
Surgery
Symptoms
Syndrome
Test
Treatment
Treatment outcome

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Treatment of cervical myelopathy in patients with the fibromyalgia syndrome: outcomes and implications