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CERVICAL SPONDYLOTIC MYELOPATHY
Cervical spondylotic myelopathy (CSM) is a progressive condition where the spinal cord in your neck becomes compressed. This is due to wear-and-tear changes in the bones, discs, and ligaments. The compression disrupts nerve signals traveling between your brain and body, leading to numbness, weakness, clumsiness, and difficulty walking. It often develops slowly over years, affecting adults over 40. However, it can also occur in younger individuals with pre-existing spinal canal narrowing.
3 percent of individuals with progressive curvature may eventually experience severe problems that can include scoliosis and back pain, spinal problems, and nerve compression causing numbness, weakness, and leg pain.
Cervical Spondylotic Myelopathy
Cervical spondylotic myelopathy (CSM) is a degenerative condition of the cervical spine characterized by compression of the spinal cord. The primary cause is due to age-related changes in the spinal structures. This condition can have a significant impact on a person’s quality of life because of neck pain, weakness, numbness. As the spinal cord becomes increasingly compressed, individuals may experience progressive neurological deficits. Additional problems include difficulty walking, loss of fine motor skills, and problems with bladder and bowel function.
Causes of Cervical Spondylotic Myelopathy:
CSM is primarily caused by degenerative changes in the cervical spine. These include disc degeneration, osteophyte formation (bone spurs), and thickening of the ligaments. These changes can result in a narrowing of the spinal canal (stenosis) and compression of the spinal cord. Furthermore, the condition can lead to symptoms of myelopathy.
Symptoms of Cervical Spondylotic Myelopathy:
Symptoms of CSM may vary depending on the severity and location of spinal cord compression. However, the common symptoms include neck pain, stiffness, arm and leg weakness, and numbness/tingling in the hands and feet. As cases worsen, there is difficulty with balance and coordination, and changes in bladder and bowel function.
Questions and Answers
What are the treatment options for cervical spondylotic myelopathy?
The treatment options for cervical spondylotic myelopathy depend on the severity of the condition and its impact on neurological function. In mild cases, non-surgical treatments such as physical therapy, medications for pain management, and lifestyle modifications may be recommended to alleviate symptoms and improve function. However, for more severe cases or those with progressive neurological deficits, surgical intervention such as decompression surgery or spinal fusion may be necessary to relieve pressure on the spinal cord and stabilize the spine.
Can cervical spondylotic myelopathy be cured?
While cervical spondylotic myelopathy cannot be cured in the traditional sense, timely and appropriate treatment can help manage symptoms, prevent further neurological decline, and improve quality of life. Non-surgical treatments and lifestyle modifications can help alleviate pain and improve function, while surgical intervention may be necessary to address severe spinal cord compression and neurological deficits. With proper management, many patients can experience significant improvements in symptoms and maintain a good quality of life.
What are the long-term outcomes for cervical spondylotic myelopathy?
The long-term outcomes for cervical spondylotic myelopathy vary depending on factors such as the severity of the condition, the effectiveness of treatment, and individual patient factors. With appropriate treatment and rehabilitation, many patients can experience improvements in symptoms, neurological function, and overall quality of life. However, in some cases, particularly those with advanced disease or significant neurological deficits, long-term complications such as chronic pain, disability, and loss of independence may occur. It is essential for patients to work closely with their healthcare providers to develop a comprehensive treatment plan and adhere to recommended lifestyle modifications to optimize long-term outcomes.
Diagnosis of Cervical Spondylotic Myelopathy:
Diagnosis involves a medical history, physical examination, and diagnostic imaging studies via X-rays, MRI, and CT scans. These tests can help evaluate the extent of spinal cord compression and identify any underlying structural abnormalities.
Risk Factors for Cervical Spondylotic Myelopathy:
Risk factors for CSM include age-related degenerative changes in the spine, previous neck injuries, occupations or activities that involve repetitive neck motion or heavy lifting, and certain genetic factors that may predispose individuals to spinal degeneration.
Non-Surgical Treatment of Cervical Spondylotic Myelopathy:
Non-surgical treatment options for CSM may include rest, physical therapy, and pain management with medications. Doctors recommend the use of cervical collars or braces to support the neck and reduce strain on the spinal cord. These conservative measures can help alleviate symptoms and improve function in some cases.
Surgical Treatment of Cervical Spondylotic Myelopathy:
Doctors may recommend surgical intervention for patients with progressive neurological deficits or severe spinal cord compression. The surgical options may include the following:
- Decompression surgery to relieve pressure on the spinal cord,
- Spinal fusion to stabilize the cervical spine, or
- Artificial disc replacement to preserve motion in the affected segment.
Complications of Cervical Spondylotic Myelopathy:
Complications of CSM may include worsening neurological deficits, loss of mobility, chronic pain, and decreased quality of life. In severe cases, untreated CSM can lead to permanent disability and loss of independence.
Physical Therapy Recommendations:
Physical therapy plays a crucial role in the management of CSM by improving strength, flexibility, and range of motion in the neck and upper extremities. Therapeutic exercises, manual therapy techniques, and modalities such as heat and cold therapy may reduce pain and improve function.
Prevention Actions for Cervical Spondylotic Myelopathy:
While our patients may not prevent age-related degenerative changes in the cervical spine entirely, individuals can take steps to reduce their risk of developing CSM. Maintaining good posture, avoiding activities that place excessive strain on the neck, and practicing proper body mechanics when lifting or carrying heavy objects can help preserve spinal health.
Related Conditions:
CSM may link to other degenerative conditions of the spine, including cervical disc herniation, cervical spinal stenosis, and cervical radiculopathy. These conditions may coexist or contribute to the development of CSM and may require additional evaluation and treatment.
Living with Cervical Spondylotic Myelopathy:
Living with CSM can be challenging, particularly for individuals with advanced disease and significant neurological deficits. However, with appropriate treatment and rehabilitation, many patients can experience improvements in symptoms and maintain a good quality of life. It is essential to work closely with healthcare providers to develop an individualized treatment plan and adhere to recommended lifestyle modifications.
Long-Term Benefits of Treatment:
The long-term benefits of treatment for CSM may include improved neurological function, reduced pain and disability, and enhanced overall quality of life. By addressing spinal cord compression and stabilizing the cervical spine, surgical intervention can help prevent further neurological decline and promote long-term functional recovery.
Cervical Spondylotic Myelopathy vs. Cervical Myelopathy
There is a subtle difference between Cervical Spondylotic Myelopathy (CSM) and Cervical Myelopathy, although the terms are often used interchangeably. Here’s the breakdown:
Cervical Myelopathy:
This is a general term for any condition that causes compression of the spinal cord in the neck region, leading to symptoms like weakness, numbness, and gait issues. The cause of Cervical Myelopathy points to various factors, including:
- Cervical spondylosis: This is a degenerative condition with wear and tear on the bones, discs, and ligaments of the cervical spine. When this degeneration compresses the spinal cord, it leads to Cervical Spondylotic Myelopathy (CSM). This is the most common cause of cervical myelopathy.
- Cervical trauma: Injuries like fractures, dislocations, or whiplash can also compress the spinal cord.
- Tumors: Both benign and malignant tumors can grow in the cervical spine and compress the cord.
- Infections: Rare cases of spinal cord infections can cause myelopathy.
Cervical Spondylotic Myelopathy (CSM):
This is a specific type of cervical myelopathy caused by cervical spondylosis the most common form of cervical myelopathy and results from compression of the spinal cord due to degenerative changes in the cervical spine. Therefore, all CSM cases are considered cervical myelopathy but not all cervical myelopathy cases are CSM. They share many symptoms, but the specific cause differentiates them. It’s important to consult an experienced spine doctor for proper diagnosis and treatment if you experience any symptoms suggestive of either Cervical Spondylotic Myelopathy or Cervical Myelopathy, regardless of the specific cause.
Reasons to Choose the Southwest Scoliosis and Spine Institute:
The Southwest Scoliosis and Spine Institute, led by Doctors Richard A. Hostin, Devish Ramnath, and Ishaq Syed, offers comprehensive care for patients with cervical spine disorders, including CSM. With offices in Dallas, Plano, and Frisco, Texas, the institute provides state-of-the-art diagnostic and treatment services, including conservative management, minimally invasive spine surgery procedures, and complex spinal surgeries. Finally, the team of experienced spine specialists is dedicated to delivering personalized, compassionate care and helping patients achieve the best possible outcomes for their spinal health.
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If you are an adult living with scoliosis or have a child with this condition and need a doctor who specializes in orthopedic surgery,
call the Southwest Scoliosis and Spine Institute at 214-556-0555 to make an appointment today.