What is cervical myelopathy?
Cervical myelopathy is damage to the part of the spinal cord that is in the neck. It refers to a constellation of symptoms and signs due to spinal cord compression in the neck.
The diagnosis can be easily missed or incorrectly attributed to the normal aging process because symptoms and signs in a patient with myelopathy can be subtle in early manifestations. However, since the natural history of cervical myelopathy is one of stepwise progression, early recognition and treatment is essential for optimal patient outcome before the onset of irreversible spinal cord damage.
How is it caused?
Patients can show a variety of symptoms.
- A slipped disk
- Bone spurs
- Cervical disks that are worn, known as degeneration
- Autoimmune disease, such as transverse myelitis, multiple sclerosis, or neuromyelitis optica
- Traumatic injury to the cervical spine
- Dislocation or fracture of the neck
- Tumors inside the spinal cord or compressing on the spinal cord
What are the symptoms?
Some of the possible symptoms are:
- Shoulder and arm pain
- Weakness in muscles
- Difficulty walking or balancing
- Tingling or numbness in the arms and legs
- Trouble flexing the neck
- Weakness below the waist or in all four limbs
- Problems with fine motor control, such as buttoning a shirt
- Bowel or bladder problems
- Irregular movements
How can it be diagnosed?
Your doctor will ask about your symptoms and medical history. A physical exam will be done focusing on weakness in muscles.
X-rays can help delineate whether there is congenital narrowing of the spinal canal, as well as bone spur formations due to degeneration, which may be pressing on the spinal cord.
Advanced tools, such as MRI or CT scans with dye, are used to confirm spinal cord compression.
How is it treated?
Discuss with your doctor about the most ideal treatment plan for you. This may include:
- Treating the cause of the myelopathy
- Doing strengthening exercises
- Improving functions that you have lost
- Helping you discover ways to cope with the condition
- Managing or reducing pain
- Teaching you ways to reduce injuries
Is surgery needed?
Surgery might be needed right away if there is structural pressure on the spinal cord. The reason for that is to attempt to avoid lasting injury.
There are multiple types of surgery and procedures to stabilize the neck, such as:
- Diskectomy- a surgical procedure which removes portion of an intervertebral disc that is putting pressure on the spinal cord or nerve root
- Laminectomy- a surgical procedure which removes a part of a vertebra, called the lamina
- Fusion of the vertebrae
Conclusion about Cervical Myelopathy
Cervical myelopathy is a disorder that is usually treated surgically. Early treatment before the onset of permanent spinal cord injury is highly recommended.
The surgical procedure chosen must be adapted to the patients' specific pattern of stenosis, symptoms, and comorbidities.