What is Cervical Myelopathy?
Cervical myelopathy is a condition characterized by compression of the spinal cord in the neck that causes clumsiness in the hands and gait imbalance.
What causes it?
Cervical myelopathy can be caused by herniated discs, bone spurs (overgrowth of bones in the neck), thickened ligaments, injuries, or tumors.
What symptoms can it cause?
Cervical myelopathy can cause a number of different symptoms including neck pain, radiating arm pain, numbness, weakness in the arms/hands/legs, problems with walking and balance, or loss of bladder/bowel control. The radiating pain is sometimes described as pins-and-needles, achy to shock-like, or burning pain which may shoot all the way down to your fingers. Symptoms can worsen over time.
How can it be treated?
There are generally three levels of treatment that Dr. Webb typically uses to treat patients with cervical myelopathy. Some patients, depending on their severity of symptoms, may progress through these levels in an accelerated fashion depending on their reported symptoms and objective physical exam findings. The goals of each level of treatment are to relieve pain and improve function. Most patients can be treated with level 1 conservative treatment including pain medication, lifestyle modification, and/or physical therapy. The remaining patients that fail conservative treatment, may require surgical intervention which is always the final and last resort. Surgery is usually done to create more space for the spinal cord and nerves.
Level I – Non-Invasive/Conservative Treatments
- Non narcotic pain medications
- Non-Steroidal Anti-Inflammatories (NSAIDs)
- Oral Steroid Medications
- Physical Therapy, Chiropractic Therapy and/or Home Exercises
- Lifestyle Modification
Level II – Spinal Injections
- Cervical Epidural Injection
- Outpatient procedures
- Done with x-ray guidance
- 1-3 injections may be needed
Level III – Surgery
Usually reserved for those who fail conservative treatment and who have progressive muscle weakness or bowel/bladder dysfunction.
Anterior cervical discectomy and Fusion (ACDF): Surgery performed by making an incision on the anterior (front) of the neck and the diseased disc + disc herniation are removed. This space is replaced with a plastic or metal cage followed by a plate and screws to fuse that level of the spine. Learn more about ACDF
Cervical Artificial Disc Replacement (ADR): Surgery performed by making an incision on the anterior (front) of the neck. The diseased disc + disc herniation are removed with a number of different instruments. This space is replaced with a metal prosthesis (artificial disc). This maintains motion in the spine and decreases the incidence of advanced degeneration of surrounding levels. Cervical ADR is usually a less common option when treating cervical myelopathy. Learn more about cervical ADR.
Posterior cervical decompression and fusion: Surgery is performed by making an incision on the posterior (back) of the neck and the compressing bone and disc herniation are removed. Screws and rods are usually needed to stabilize the spine. Learn more about posterior cervical decompression and fusion.