Cervical myelopathy is a condition in which spinal cord cells in the neck region have died due to long-term compression of the spinal cord. It can cause severe and even irreversible loss of nerve function, including paralysis. Treatment for cervical myelopathy can relieve pressure on the spinal cord, alleviate symptoms, and prevent irreversible nerve damage from occurring. An early diagnosis is critical for a positive outcome.
Symptoms of cervical myelopathy can include:
- Neck pain or soreness
- Sometimes minimal or no pain in the neck
- Stiffness in the neck, sometimes with reduced range of motion
- A grinding sound with certain neck movements
- Pain, numbness, weakness, or tingling in the shoulders, arms, hands, fingers
- Pain may be dull or sharp
- Problems with coordination, motor function, balance, reflexes, dexterity
- “Electric shock” nerve pain extending into the arms and legs, especially when bending forward
- A feeling of heaviness or stiffness in the legs while walking
- Loss of nerve function (may be irreversible)
- Paralysis (may be irreversible)
- Symptoms tend to worsen slowly
- Symptoms may flare during certain activities
- Symptoms may go through cycles of remaining stable and rapidly getting worse
Because cervical myelopathy is caused by long-term compression of the spinal cord (spinal stenosis), surgery is often the only effective way to prevent permanent nerve damage.
- Conservative Treatments: In rare cases, treatments such as lifestyle modifications, injections, physical therapy, etc. may be effective in relieving symptoms. These treatments may also be tried in conjunction with surgery to improve outcomes.
- Cervical Stenosis Surgery (Spinal Decompression): Stenosis surgery, or spinal decompression, is often necessary for effective treatment of cervical myelopathy. This surgery removes any excess bone and arthritic debris to relieve pressure on the spinal cord. It also aligns and decompresses the joints of the cervical spine. This can alleviate symptoms and prevent long-term damage to the nerves.
- Disc Replacement Surgery: Where appropriate, disc replacement surgery can replace a degenerative disc with an artificial disc to stop ongoing spinal cord compression.
- Minimally Invasive Spinal Fusion: Minimally invasive spinal fusion surgery can relieve compression in the spine by permanently fusing together two or more spinal vertebrae. This restricts some mobility of the spine but can alleviate symptoms.
Frequently Asked Questions
Because of the dangers of prolonged spinal cord compression, getting an accurate diagnosis is critical for patients experiencing the symptoms listed above. Unfortunately, many of the symptoms of cervical myelopathy can also be caused by other conditions. This often leads to cervical myelopathy being misdiagnosed as other conditions such as peripheral neuropathy or carpal tunnel syndrome. In conjunction with evaluation of current symptoms, a confirmation of spinal stenosis, osteoarthritis, and/or degenerative spondylolisthesis (slipped disc) may help guide a diagnosis. A diagnosis of cervical myelopathy can be confirmed with a detailed history and examination, including diagnostic testing.
Cervical myelopathy is caused by spinal stenosis, a condition where bones, discs, and/or arthritic debris compress the spinal cord. Many affected patients also have a history of arthritis. If patients with spinal stenosis do not undergo treatment to relieve compression of the spinal cord, the pressure will continue and may eventually lead to cellular death, or myelopathy.
Cervical myelopathy can have major long-term consequences if left untreated. It is not the beginning of a condition, but rather a sign that an ongoing spinal condition (stenosis) has progressed to a point where spinal cord cells die. The death of spinal cord cells can cause paralysis and irreversible loss of bodily function. Timely action is critical even if the condition currently appears stable, since at any point, cervical myelopathy can rapidly worsen. If you have received a diagnosis of cervical myelopathy, it is strongly recommended that you get treatment right away to minimize the risk of permanent negative effects on your health and quality of life.
Most patients with cervical myelopathy will be advised to undergo surgery. Even many patients for whom cervical stenosis has not yet led to myelopathy will often need to get surgery. Surgery can relieve pressure on the spinal cord and prevent permanent nerve damage from occurring.