CERVICAL MYELOPATHY

Cervical Myelopathy Causes

In addition to progressive wear and tear of the spine, Cervical myelopathy can occur by hardening of the ligaments covering the brain and spinal cord. Also, the posterior longitudinal ligament hardening occurs more frequently. Therefore. implying that the soft tissue that links the bones of the spine loses flexibility and gradually transforms into bone. As the ligament thickens, it begins to take up more space and exert pressure on the spinal cord, resulting in this condition. The most prevalent site occurs in the neck region of the spine.

Any of these areas might become affected by disorders or degeneration, but aging provides the most common cause of cervical myelopathy.

The following spinal disorders can also cause cervical myelopathy

• Herniated cervical disc. A herniated disc can bulge or burst in a painful manner. Pressure on the spinal cord or nerve roots may happen as a result of this.
• Rheumatoid arthritis. This autoimmune condition produces inflammation. The facet joints in the cervical spine can become damaged by inflammation, resulting in abnormal vertebral movement.
• Trauma. An abrupt injury, such as a vehicle accident or a sports collision, can cause the neck to hyperextend, compressing the spinal cord.
• Other cervical spine injuries, such as whiplash
• Spinal infections
• Spinal tumors and cancers

Cervical Myelopathy Symptoms

The beginning of cervical stenosis with myelopathy may go unnoticed in the early stages. For example, a tiny difference in handwriting or taking longer to get ready in the morning may become too subtle to detect. Symptoms may become more obvious over time and may involve one or more of the following:

• Hand weakness or numbness can affect grip strength. Other regions of the body, such as the arms or legs, may also suffer from these sensations.
• Typing, handwriting, buttoning a garment, and placing a key in a door may all become more difficult for the person. 
• The legs may seem heavy, or the person may find it difficult to move faster. If the legs don’t move where they’re supposed to, balance issues might arise, necessitating the use of a walking cane and/or handrails.
• It’s possible that pain develops in the neck or that your range of motion becomes limited. Certain motions may cause the neck to create grinding noises termed crepitus.
• Intermittent electric-shock-like pain may radiate into the arms and legs, especially while bending the head forward (known as the Lhermitte phenomenon). Pain, tingling, weakness, and/or numbness may occur down the arm and/or into the hand if a nerve root also impinges.

Symptoms and their evolution emerge at different times for different people. Additionally, the rate at which symptoms worsen over time may also vary. And then symptoms may progress quickly for a while before settling down. Alternatively, the symptoms may appear gradually but consistently.

Diagnosing Myelopathy

Myelopathy’s most prevalent symptoms are not specific to this disorder. Unfortunately, they often mistakenly indicate other diseases. To provide an accurate diagnosis, our doctors will conduct a physical exam and prescribe imaging testing to correctly diagnose this condition. 

Diagnostic Details

• The doctor will begin by conducting a thorough medical history and performing a physical exam. They will ask about your symptoms, such as neck pain, weakness, or numbness, and any relevant medical history. During the physical exam, the doctor will check your reflexes, muscle strength, and sensation in your arms and hands.
• To confirm a diagnosis of cervical myelopathy, the doctor will likely order imaging tests to look for signs of spinal cord compression or damage. These may include:
  • X-rays: This imaging test uses radiation to create images of the bones in the neck, which can show if there are any abnormalities, such as bone spurs or narrowed spinal canal.
  • Magnetic resonance imaging (MRI): This test uses powerful magnets and radio waves to create detailed images of the spinal cord and surrounding tissues. An MRI can show compression or damage to the spinal cord.
  • Computed tomography (CT) scan: This test uses X-rays and computer processing to create detailed images of the spine. It will display bony abnormalities, such as spinal stenosis.
  • Electromyography (EMG) and nerve conduction studies evaluate nerve function and determine if the nerves in the neck or arms appear damaged.

Once a diagnosis of cervical myelopathy becomes confirmed, our doctors will work with the patient to develop an individualized treatment plan based on the symptoms and underlying cause of the condition.

Managing and Treating Myelopathy?

The two main types of treatments for cervical myelopathy are non-surgical and surgical procedures. Here’s a breakdown of the common non-surgical and surgical procedures:

Non-Surgical Procedures:

• Medications: Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and corticosteroids manage pain and inflammation associated with cervical myelopathy.
• Physical therapy: Physical therapy will improve the range of motion, strengthen muscles, and relieve pressure on the spinal cord. This can help alleviate symptoms such as pain and weakness.
• Cervical traction: Cervical traction is a non-surgical procedure that uses a device to gently stretch the neck and relieve pressure on the spinal cord. This can help improve symptoms such as neck pain and tingling in the arms.
• Bracing: In some cases, a cervical collar or brace will help immobilize the neck and reduce pressure on the spinal cord.

Surgical Procedures:

• Anterior cervical discectomy and fusion (ACDF): ACDF is a surgical procedure that involves removing the damaged or herniated disc in the neck and fusing the adjacent vertebrae together. This can help alleviate pressure on the spinal cord and improve symptoms such as pain and weakness.
• Cervical laminectomy: Cervical laminectomy is a surgical procedure that involves removing the lamina, or the bony arches of the vertebrae, to create more space in the spinal canal. For instance, this can help relieve pressure on the spinal cord and improve symptoms such as numbness and tingling in the arms.
• Artificial disc replacement: In this surgical procedure, the damaged disc in the neck is removed and replaced with an artificial disc. This can help maintain spinal flexibility and alleviate symptoms such as neck pain and stiffness.
• Posterior cervical laminoplasty: This procedure involves creating more space in the spinal canal by repositioning the vertebrae without removing the bone. This can help alleviate pressure on the spinal cord and improve symptoms such as numbness and weakness in the arms.

It’s important to note that the choice of treatment for cervical myelopathy depends on several factors such as the severity of symptoms, age, general health, and underlying cause of the condition. Also, our doctors will assess all of these factors and recommend the most appropriate treatment for each individual patient.

Myelopathy Prevention

Myelopathy is not always preventable. The condition is sometimes caused by typical aging, wear, and tear, and can be avoided by strengthening and caring for your spine.  You can eliminate the potential of getting this condition by following the following hints:

• Lift heavy objects safely. Bend at the knees, tense your stomach muscles, and rise with your legs. Find someone to assist you if you can’t lift anything on your own.
• Maintain a healthy weight. The spine is strained even more by extra weight.
• Stop smoking. Smokers’ spinal discs degrade more quickly.
• Strengthen back and core muscles. Crunches, planks, and Pilates are exercises that can help.

The Prognosis for Myelopathy Patients?

Myelopathy might worsen over time if left untreated. The nerves that govern bodily motions and functions can become damaged by spinal compression. Because doctors cannot reverse nerve damage, it is critical to get treatment as soon as symptoms appear. Early detection and therapy can help you improve your health and, in some cases, reverse spinal cord injury.

When you come to the Southwest Scoliosis and Spine Institute, you will find Experts and specialists who focus on diagnosing and treating scoliosis and other complex spine conditions including spine and revision surgery for children and adults. At our practice, we encourage people to get checked early on for neck pain.  In the majority of cases, our findings are minor, but in certain cases, early detection and treatment can have a positive effect on future decades of a wonderful life. So pick up the phone today and give us a call.

Why Choose the Southwest Scoliosis and Spine Institute

There are many reasons why you should choose the Southwest Scoliosis and Spine Institute to treat your lumbar spinal scoliosis. Here are a few:

• They have a team of experienced and board-certified surgeons who specialize in treating spinal conditions, including scoliosis.
• They offer a variety of treatment options, including non-surgical and surgical treatments.
• They have a state-of-the-art facility that is equipped with the latest technology for diagnosing and treating spinal conditions.
• They have a reputation throughout the Nation for providing the very best spinal care for their patients.
• They are conveniently located in three locations in Dallas, Plano, and Frisco, Texas.

Finally, if you are considering treatment for cervical myelopathy, we urge you to schedule an appointment with the Southwest Scoliosis and Spine Institute. At the meeting, they can help you understand your condition and develop a treatment plan that is right for you.

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National Institute of Health: Cervical Myelopathy
Physiopedia: Cervical Myelopathy