Cervical myelopathy
What is cervical myelopathy?
The cervical spine contains seven vertebrae (C1 to C7), with six intervertebral discs and eight nerve roots that primarily control the function of the shoulders, arms and hands. Cervical myelopathy is a medical condition that affects the spinal cord in the neck region and occurs when the spinal cord is compressed due to a narrowing of the spinal canal in the neck.
What are the main symptoms of cervical myelopathy?
Cervical myelopathy produces two types of symptoms: those that are felt in the neck and those that manifest in other parts of the body, either in the area where the spinal cord is compressed or below that area.
Symptoms in the neck may be pain, stiffness or reduced range of motion.
However, not all neck pain is attributable to myelopathy. Very often these pains have a muscular origin. Your specialist will be able to advise you.
When the disease progresses, you may experience a sharp, stabbing pain that originates in the neck and travels down the spine.
Other symptoms of cervical myelopathy include weakness in the arms and legs, difficulty walking, pain in the neck and arms, numbness, tingling, clumsiness or problems with coordination and balance, difficulty handling small objects. Changes in limb reflexes, loss of bladder control and neck pain may also occur.
What are the causes of cervical myelopathy?
The most common causes of cervical myelopathy are aging and age-related degeneration of the intervertebral discs, which can put pressure on the spinal cord. It is known as cervical spondylotic myelopathy and is most common among the population over 50 years of age. This gradual degeneration of the cervical spine often results in a narrowing of the spinal canal in the neck, known as cervical spinal stenosis.
Cervical myelopathy can also be caused by traumatic neck injuries, such as car accidents or falls. Other causes include herniated discs, osteoarthritis, infections and, more rarely, tumors.
How is cervical myelopathy diagnosed?
The diagnosis of cervical myelopathy is based on the patient’s medical history, symptoms and physical examination (measuring muscle strength and reflexes) and assessment of the results of imaging tests, such as MRI, X-rays and CT scans.
Neurophysiological studies (mainly electromyograms and neurographies) can also be performed to assess how the nerves in the arms and hands (and occasionally also in the lower limbs) communicate with the brain via the spinal cord.
What is the treatment for cervical myelopathy?
Treatment for cervical myelopathy will depend on the severity of symptoms and the disease.
There are some non-surgical options to alleviate the symptoms of cervical myelopathy, such as physical therapy to improve muscle strength and coordination, medications to relieve pain and reduce inflammation and, occasionally, the use of a cervical collar.
In severe cases of cervical myelopathy, surgery may be necessary to decompress the spinal cord and prevent permanent damage. Surgery may involve removal of parts of the cervical bone to increase space in the spinal canal, or fusion of the neck bones to stabilize the spine.
These surgeries can be performed from the back of the neck (from behind) or from the front of the neck (from the front).
Your surgeon will be able to recommend which treatment approach is most appropriate for your situation.
Although it is not always possible to prevent cervical myelopathy, taking steps to care for your back may reduce the likelihood or severity of some back injuries.
If you think you have symptoms of cervical myelopathy, it is important to see your doctor for an accurate diagnosis and a personalized and appropriate treatment proposal.