Cervical Myelopathy

This is a problem that affects your spinal cord. It happens when something presses harmfully against it. Your spinal cord is the main nerve pathway between your brain and your body. Pressure on it can cause problems throughout your body.

Cervical Myelopathy

Introduction

Cervical myelopathy is damage to the part of the spinal cord that is in the neck. It is refers to a constellation of symptoms and signs due to spinal cord compression in the neck. Because symptoms and signs in a patient with myelopathy can be subtle in early manifestations, the diagnosis may easily be missed or incorrectly attributed to &ldquonormal&rdquo aging process. However, because 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.

Causes

Patients present with a variety of symptoms.

  • A slipped disk
  • Cervical disks that are worn, known as degeneration
  • Tumors inside the spinal cord or compressing on the spinal cord
  • Bone spurs
  • Dislocation or fracture of the neck
  • Traumatic injury to the cervical spine
  • Autoimmune disease, such as transverse myelitis, multiple sclerosis, or neuromyelitis optica

Symptoms

Symptoms may include:

  • Pain in the shoulder and arms
  • Tingling or numbness in the arms and legs
  • Trouble walking or balancing
  • Muscle weakness
  • Problems flexing the neck
  • Lightheadedness
  • Problems with fine motor control, such as buttoning a shirt
  • Irregular movements
  • Bowel or bladder problems
  • Weakness below the waist or in all four limbs

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. It will focus on any muscle weakness.

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 studies, such as MRI or CT scans with dye, are the tools of choice in confirming spinal cord compression.

Treatment

Talk with your doctor about the best treatment plan for you. This may involve:

  • Treating the cause of the myelopathy
  • Improving functions that you have lost
  • Reducing or managing pain
  • Doing strengthening exercises
  • Teaching you ways to reduce injuries
  • Helping you learn ways to cope with the condition

Surgery

If there is structural pressure on the spinal cord, you may need surgery right away. This is to attempt to avoid lasting injury. There are many different kinds of surgery and procedures to stabilize the neck, such as:

  • Diskectomy &mdash a surgical procedure to remove part of an intervertebral disc that is putting pressure on the spinal cord or nerve root
  • Laminectomy &mdash a surgical procedure to remove a portion of a vertebra, called the lamina
  • Fusion of the vertebrae

Conclusion

Cervical myelopathy is a disorder that is typically treated surgically. Early treatment before the onset of permanent spinal cord injury is recommended. The surgical procedure chosen must be tailored to the patient&rsquos specific pattern of stenosis, comorbidities, and symptoms.

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