What is Cervical Myelopathy?
Cervical myelopathy is a condition caused by compression of the spinal cord in the neck (cervical spine).
Unlike conditions that affect individual nerves, cervical myelopathy involves the spinal cord itself, which can lead to more widespread neurological symptoms affecting the arms, legs, and overall coordination.
What Causes Cervical Myelopathy?
The most common cause is degenerative changes in the cervical spine, including:
- Disc bulging or herniation
- Bone spurs (osteophytes)
- Thickened ligaments
- Narrowing of the spinal canal (cervical stenosis)
These changes can gradually compress the spinal cord over time.
Symptoms
Cervical myelopathy often presents subtly at first but can progressively worsen.
Common symptoms include:
- Imbalance or difficulty walking (often one of the earliest and most important signs)
- Hand weakness or clumsiness (difficulty with fine motor tasks like buttoning or writing)
- Numbness or tingling in the arms or hands
- Weakness in the arms and/or legs
- Neck pain (not always present)
Because the spinal cord is involved, symptoms may affect both sides of the body and overall coordination.
How is it Diagnosed?
Diagnosis is based on a combination of clinical examination and imaging.
Imaging studies may include:
- MRI (most important) to evaluate spinal cord compression
- CT scan to assess bony anatomy
- X-rays to evaluate alignment and stability
Radiographic findings typically show:
- Narrowing of the spinal canal
- Compression of the spinal cord
- Degenerative changes such as discs, bone spurs, and ligament thickening
Why is Early Recognition Important?
Cervical myelopathy is often a progressive condition. Without treatment, symptoms may worsen over time and can become permanent.
Because of this, once a patient is clinically myelopathic, surgical treatment is often recommended to prevent further neurological decline.
Treatment
Conservative Management
Unlike many other spine conditions, conservative treatment is limited in cervical myelopathy once clear spinal cord compression and symptoms are present.
Observation may be appropriate in very mild or early cases, but progression is a key concern.
Surgical Treatment
The primary treatment for symptomatic cervical myelopathy is surgical decompression of the spinal cord.
Surgery typically involves:
- Decompression to relieve pressure on the spinal cord
- Fusion to stabilize the spine when necessary
The approach depends on the patient’s anatomy and imaging findings:
- Anterior (front) approach:
Often used when compression is primarily from discs or bone spurs in front of the spinal cord - Posterior (back) approach:
Used when there is multilevel compression or certain alignment considerations
The choice of approach is carefully individualized.
Our Approach
We emphasize early recognition and timely treatment of cervical myelopathy to prevent permanent neurological deficits.
Surgical planning is highly individualized, taking into account:
- Location and extent of compression
- Spinal alignment
- Patient symptoms and overall health
Our goal is to safely decompress the spinal cord and stabilize the spine when needed, while utilizing modern, minimally invasive techniques whenever appropriate to reduce recovery time and optimize outcomes.
View the approach