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Cervical Myelopathy

Overview

Cervical myelopathy, also known as cervical spondylotic myelopathy, is a condition in which the spine becomes compressed due to wear and tear on the body over time. It is especially common among older adults and a common source of disability. The condition usually progresses with age and can eventually lead to reduced mobility and altered gait or even loss of motor skills in the upper body.

  • Symptoms

    • Diminished ability to grip or hold items
    • Frequent falls
    • Loss of balance and/or coordination
    • Loss of bladder or bowel control
    • Loss of motor skills in the upper body
    • Neck pain
    • Reduced range of motion
    • Weakness and numbness in the upper body
  • Prevention

    • You cannot prevent cervical myelopathy. It is caused by a natural breakdown of the body that occurs with age.
  • Risk factors

    • Advanced age
    • Arthritis of the spine
    • History of or predisposition to bone spurs
    • Spinal cord trauma
  • Diagnosis

    • Medical history and symptom review. At your appointment, your medical provider will first carefully review your medical history and overall health, along with your current symptoms and when and how they occur.
    • Physical examination. After gathering your medical history and other pertinent details about your condition, your provider will perform a thorough exam of your neck, upper extremities and legs. During this exam, he or she will look specifically for functions impacted by spinal compression, including changes to your reflexes, numbness or weakness in your upper extremities, diminished mobility, a loss of balance, leg weakness, and muscle atrophy.
    • Imaging tests. Because the spine contains both bones and soft tissues, your medical provider will likely order a full spectrum of imaging tests. This may include X-rays and CT scans to fully visualize the bones and any narrowing of the spinal canal, as well as an MRI that can provide images of the body’s soft tissues.
  • Treatment

    • Early intervention is important to the successful treatment of cervical myelopathy, since the condition can worsen if left untreated.
    • In early or mild cases of cervical myelopathy, your medical provider may recommend relieving pain using over-the-counter or prescription pain and anti-inflammatory medications. In some cases, injected steroids may also help provide relief.
    • In combination with medication, your provider may also suggest the short-term use of a neck brace or cervical collar to rest the neck and limit its movement.
    • In many cases, physical therapy can be helpful in teaching you methods to modify normal daily activities or in restoring natural movements to diminish pain or weakness.
    • If conservative treatment is not effective or if the condition worsens, surgery may be required. There are four main types for cervical myelopathy — anterior cervical diskectomy and fusion, anterior cervical corpectomy and fusion, laminectomy, and laminoplasty. These procedures remove pieces of bone or other material in an effort to decompress the spinal cord.
  • Follow-up care

    • Following a surgical procedure for cervical myelopathy, you will likely need to remain in the hospital for a period of time. This will vary depending on the type of surgical procedure and the severity of your condition.
    • Your medical provider will outline a specific plan for postsurgical care. Be sure to carefully follow all guidelines for proper care.
    • If you have undergone an anterior cervical procedure, you may experience some difficulty swallowing food and may need to eat a diet of softer foods during the first days of postoperative care.
    • Following recovery from your surgical procedure, your medical provider will likely refer you for physical therapy to help you regain range of motion and mobility.