What is Cervical Myelopathy? Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr Prachi Rahul Pawar , Neurologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Cervical myelopathy is a condition caused by compression of the spinal cord in the neck (cervical spine), often due to age-related degeneration, herniated discs, bone spurs, or spinal injuries. It can interfere with the transmission of nerve signals between the brain and the rest of the body, leading to neurological symptoms. Common symptoms include neck pain, numbness or weakness in the arms and legs, difficulty walking, poor balance, and reduced hand coordination.

Diagnosis usually involves a physical examination along with imaging tests such as MRI, CT scan, or X-rays to identify spinal cord compression. Early diagnosis and appropriate treatment, including medications, physical therapy, or surgery, can help relieve symptoms, prevent permanent nerve damage, and improve quality of life.

What are the Symptoms of Cervical Myelopathy?

The symptoms of cervical myelopathy can vary widely and often develop gradually. Common symptoms include:

Neck Pain: Persistent neck pain or stiffness is a common early symptom.
Weakness: Muscle weakness, particularly in the arms and hands.
Numbness and Tingling: Often felt in the hands, fingers, and sometimes legs.
Coordination Issues: Difficulty with fine motor skills, such as buttoning a shirt or writing.
Balance Problems: Unsteady gait or frequent falls.
Bladder and Bowel Dysfunction: In severe cases, loss of control over bladder and bowel functions.

If you experience any of these symptoms, it's essential to seek medical attention promptly for an accurate diagnosis and timely treatment.

What are the Causes of Cervical Myelopathy?

The primary cause of cervical myelopathy is spinal cord compression, which can result from several factors:

Degenerative Disc Disease

As we age, the intervertebral discs in the spine can degenerate, leading to reduced disc height and the development of bone spurs. These changes can narrow the spinal canal and compress the spinal cord.

Herniated Discs

A herniated or slipped disc occurs when the soft inner material of the disc protrudes through the outer layer, putting pressure on the spinal cord.

Spinal Stenosis

Spinal stenosis is the narrowing of the spinal canal, which can compress the spinal cord and nerves. This condition is often a result of degenerative changes.

Trauma

Injuries to the cervical spine, such as fractures or dislocations, can lead to spinal cord compression and subsequent myelopathy.

Other Causes

Less common causes include tumors, infections, and inflammatory diseases that affect the spinal cord.

When should you see a Doctor for Cervical Myelopathy?

You should seek medical attention if you experience symptoms of cervical myelopathy, as early diagnosis and treatment can help prevent permanent spinal cord damage and neurological complications. Timely evaluation by a Neurologists can help confirm the diagnosis, recommend appropriate imaging tests, and determine the most effective treatment plan to preserve nerve function and improve quality of life.

Persistent Neck Pain: Ongoing or worsening neck pain that does not improve with rest, medications, or physical therapy.
Weakness in the Arms or Legs: Progressive muscle weakness, difficulty lifting objects, climbing stairs, or performing daily activities.
Numbness or Tingling: Persistent numbness, tingling, or reduced sensation in the arms, hands, legs, or feet.
Difficulty Walking: Problems with balance, coordination, frequent falls, or an unsteady gait that gradually worsens.
Loss of Hand Dexterity: Difficulty writing, buttoning clothes, holding objects, or performing fine motor tasks.
Bladder or Bowel Dysfunction: Loss of bladder or bowel control, urinary urgency, or difficulty passing urine requires immediate medical attention.
Progressive Neurological Symptoms: Increasing weakness, stiffness, muscle spasms, or worsening neurological symptoms should be evaluated promptly.
History of Neck Injury or Spinal Disorders: Individuals with previous neck trauma, cervical spine degeneration, herniated discs, or abnormal MRI findings should consult a neurosurgeon promptly if symptoms develop or worsen.

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How is Cervical Myelopathy Diagnosed?

Accurate diagnosis is essential for effective treatment. The diagnostic process typically involves:

Medical History and Physical Examination

A thorough medical history and physical examination can help identify symptoms and potential causes of cervical myelopathy.

Imaging Studies

Imaging studies such as X-rays, MRI (Magnetic Resonance Imaging), and CT (Computed Tomography) scans provide detailed images of the cervical spine, helping to identify areas of compression and degeneration.

Electromyography (EMG) and Nerve Conduction Studies

These tests evaluate the electrical activity of muscles and the speed of nerve signals, helping to assess the extent of nerve damage.

What are the Treatment Options for Cervical Myelopathy?

Treatment for cervical myelopathy aims to relieve symptoms, prevent further damage, and improve the patient's quality of life. The treatment approach can vary depending on the severity of the condition.

Non-Surgical Treatments

Medications

Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids can help reduce inflammation and alleviate pain.

Physical Therapy

Physical therapy can improve strength, flexibility, and coordination. Specific cervical myelopathy exercises may include neck stretches, strengthening exercises, and balance training.

Immobilization

In some cases, a cervical collar may be recommended to immobilize the neck and reduce pressure on the spinal cord.

Surgical Treatments

When non-surgical treatments are insufficient, surgery may be necessary to relieve spinal cord compression and prevent further neurological deterioration. Common surgical options include:

Anterior Cervical Discectomy and Fusion (ACDF)

This procedure involves removing the damaged disc and fusing the adjacent vertebrae to stabilize the spine.

Posterior Cervical Laminectomy

In this procedure, the surgeon removes the lamina (the back part of the vertebra) to create more space for the spinal cord.

Cervical Corpectomy

This surgery involves removing a portion of the vertebra and discs to decompress the spinal cord, followed by spinal fusion to maintain stability.

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What is the Prognosis and Long-Term Outlook for Cervical Myelopathy?

The prognosis for cervical myelopathy varies depending on the severity of the condition and the timeliness of treatment. Early diagnosis and appropriate treatment can significantly improve outcomes and prevent permanent neurological damage.

Rehabilitation

Post-surgical rehabilitation is crucial for recovery. Physical therapy, occupational therapy, and other rehabilitation programs can help patients regain strength, mobility, and function.

Lifestyle Modifications

Making lifestyle changes, such as maintaining a healthy weight, practicing good posture, and avoiding activities that strain the neck, can help prevent further spinal degeneration and reduce the risk of recurrence.

What are the Risk Factors for Cervical Myelopathy?

Certain factors can increase the likelihood of developing cervical myelopathy:

Age: The risk increases with age, particularly after 50.
Genetics: A family history of spinal disorders may predispose individuals to cervical myelopathy.
Occupation: Jobs that involve repetitive neck movements or heavy lifting can contribute to spinal degeneration.
Previous Neck Injuries: A history of neck injuries can increase the risk of developing myelopathy.

Frequently Asked Questions

1. What are the symptoms of cervical myelopathy?

Symptoms include neck pain, difficulty with balance, muscle weakness, numbness, and loss of fine motor skills in the hands.

2. What causes cervical myelopathy?

It is caused by compression of the spinal cord in the cervical (neck) region, often due to degenerative changes like herniated discs or arthritis.

3. How is cervical myelopathy treated?

Treatment includes physical therapy, medications for pain relief, and in severe cases, surgery to decompress the spinal cord and prevent further damage.