Cervical Myelopathy

Cervical myelopathy is a condition characterized by compression or damage to the spinal cord in the neck (cervical) region. It is usually caused by degenerative changes in the spine, such as spinal stenosis (narrowing of the spinal canal) or herniated discs, but can also result from trauma or other spinal disorders.

The compression of the spinal cord in cervical myelopathy can lead to a variety of symptoms, which may include:

1. Neck pain: Often a persistent, dull ache in the neck.

2. Weakness: Muscle weakness in the arms, hands, or legs, which can affect coordination and fine motor skills.

3. Numbness and tingling: Sensations of numbness, tingling, or a “pins and needles” feeling in the arms, hands, or legs.

4. Loss of balance and coordination: Difficulty with balance, coordination, and walking.

5. Fine motor skill problems: Difficulty with tasks that require fine motor skills, such as buttoning clothes, writing, tying shoelaces, or using tools/utensils.

6. Changes in reflexes: Reflexes in the arms or legs may become exaggerated or diminished.

7. Electric shock-like sensations down one’s back upon bending, tilting, or twisting your neck.

Oftentimes, those afflicted will complain “my hands don’t quite work like how they used to, and I’m having a lot of trouble with stairs”.  Some even start borrowing a cane because they feel unsure of their balance.

If cervical myelopathy is suspected, a thorough evaluation by a healthcare professional specializing in spine disorders, such as a neurosurgeon or orthopedic spine surgeon, is necessary. Diagnosis often involves a combination of medical history review, physical examination, and diagnostic imaging tests, such as MRI or CT scans, to assess the condition of the spinal cord and identify the cause of compression.

Cervical myelopathy is potentially dangerous.  By its nature, it increases one’s risk for spinal cord injury from falls, accidents, or even minor injury.  Left alone, symptoms progress until people are left with permanent weakness, or even paralysis.  And it’s fairly common.

The treatment of cervical myelopathy depends on the severity of symptoms, the underlying cause, and the individual’s overall health. Options for treatment may include:

1. Non-surgical treatment:

   – Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or corticosteroids may be prescribed to reduce pain and inflammation.

   – Physical therapy: Exercises and techniques aimed at improving strength, flexibility, and overall mobility.

   – Assistive devices: The use of neck braces or collars to provide support and stability to the neck.

– Regular screening: Stenosis is progressive and routine screening is critical to ensure symptoms don’t get worse.  

2. Surgical treatment:

   – Decompressive surgery: The mainstay of surgical treatment for cervical myelopathy is decompression, which involves removing the source of compression on the spinal cord. This may include removing herniated discs, bone spurs, or part of the vertebral bone to create more space for the spinal cord.

   – Spinal fusion: In some cases, spinal fusion may be performed in conjunction with decompression to provide stability to the spine.

The decision to pursue surgical treatment depends on several factors, including the severity of symptoms, the impact on daily activities and quality of life, and the individual’s overall health. At Total Orthopedics and Sports Medicine you can receive a consultation with a spine specialist to determine if you are suffering from cervical myelopathy as well as the most appropriate treatment approach.  We employ minimally invasive techniques and a common-sense approach to ensure we get you back on your feet the same day, and back to life soon.