Overview
Any space-occupying lesion within the cervical spine with the potential to compress the spinal cord can cause cervical myelopathy. The most common type is cervical spondylotic myelopathy, which happens after natural changes to your body as you age. It can cause neck pain, muscle weakness and numbness, among other symptoms. Surgery treats cervical myelopathy.
Once the disorder is diagnosed, complete remission to normality never occurs and spontaneous temporary remission is uncommon. In 75% of the patients, episodic worsening with neurological deterioration occurs, 20% have slow steady progression, and 5% experience rapid onset and progression.
Symptoms and Causes
The symptoms of cervical myelopathy and cervical spondylotic myelopathy include:
- Neck pain or stiffness.
- Numbness or tingling in your hands and arms.
- Muscle weakness in your hands and arms.
- Loss of balance and difficulty walking.
- Difficulty with fine motor skills (like buttoning a shirt or holding silverware).
Common causes of compression include:
- Bone spurs.
- Herniated disk.
- Narrow cervical canal (birth defect).
- Rheumatoid arthritis.
- Spondylolisthesis.
- Spinal degeneration.
- Spinal stenosis.
- Traumatic injury.
- Tumor.
Cervical spondylotic myelopathy happens due to age-related changes that affect the structure and function of parts of your spine in your neck (spinal degeneration). These changes narrow the spinal canal (the opening where your spinal cord sits), which puts pressure on your spinal cord. Degenerative changes are a natural part of getting older.
Risk factors for cervical myelopathy..
Cervical myelopathy can affect anyone at any age. Studies show it’s more common among people of Asian descent older than 30 years.
Cervical spondylotic myelopathy can affect anyone as well, but it’s more common among men and people assigned male at birth and adults after age 40. The average age of a diagnosis is 64.
If left untreated, cervical myelopathy symptoms may get worse. This might cause:
- Severe pain.
- Bowel and bladder dysfunction.
- Nerve damage.
- Difficulty walking (instability, high risk of falls).
- Limited use of your fingers, hands and arms.
- Paralysis.
Diagnosis and Tests
A healthcare provider will diagnose cervical myelopathy after a physical exam, a neurological exam and other testing. During the exams, your provider will review your symptoms and medical history. They may also test your balance, reflexes and dexterity, and observe you walking (if possible) to better understand how symptoms affect you.
Your provider may order imaging tests to look at your spine. Imaging tests may include:
- X-ray.
- MRI.
- CT scan.
- Myelogram.
Management and Treatment
There isn’t a cure available for all causes of cervical myelopathy. Surgery can decrease symptoms and prevent complications. Even after treatment, age-related changes may affect more than one area of your spine.
Nonsurgical cervical myelopathy management
A healthcare provider may recommend nonsurgical options to help you manage mild cervical myelopathy. They may include:
- Wearing a neck brace.
- Participating in physical therapy.
- Taking medications.
Surgical cervical myelopathy treatment
You may be a candidate for surgery if you have:
- Severe pain.
- Muscle weakness.
- Numbness.
- Balance and walking challenges.
- Difficulty with fine motor skills.
The procedure that a surgeon recommends can vary based on your symptoms, general health and your age. It may include one or a combination of the following:
- Diskectomy.
- Disk replacement.
- Laminectomy.
- Laminoplasty.
- Spinal fusion.
surgeon will explain the possible risks before the procedure so you can make an informed decision about your health, also post surgery specific instructions on how to take care of yourself and when you should see them for a follow-up visit.
Prevention
You can’t prevent all causes of cervical myelopathy. Spinal cord compression related to cervical spondylotic myelopathy happens due to natural changes to your body as you age, which you can’t prevent. But you can reduce your risk of injury by taking safety precautions and avoiding high-risk or dangerous activities.
Conclusion
Your spinal cord has an important job in your body. Unpredictable things, like an accident or natural changes that happen as you age, can put pressure on your spinal cord. Like a bridge in a busy town, wear and tear is unavoidable. Your body needs maintenance and care in the same way a city’s infrastructure does to make sure vital parts have the support they need to function. This is especially important with cervical myelopathy.
A healthcare provider can help you manage symptoms and relieve pressure on your spinal cord. This may require surgery. While a procedure on your neck may be scary to think about, your care team will take extra precautions to make sure you’re safe and avoid complications.
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