Cervical myelopathy is a condition where the spinal cord is compressed within the spinal canal and leads to nerve dysfunction affecting the feeling in the hands and feet, control of fine hand movements (such as writing or doing up buttons) and coordination of walking and balance.
Why does it occur?
This most commonly occurs because of degeneration within the bones and joints of the spinal column causing the narrowing of the spinal canal. Occasionally spinal cord compression can occur due to other reasons such as disc prolapse, infection, fracture or tumour. People who are born with a narrow spinal canal may have a predisposition to developing myelopathy.
The symptoms of myelopathy can vary widely between patient and can come on very slowly over time or sometimes over a matter of weeks. This depends not only on the severity of the compression but also on the degree of damage that has occurred.
How is cervical myelopathy diagnosed?
Cervical myelopathy is diagnosed through a combination of taking a history of the symptoms from the patient, careful neurological examination by your specialist, and imaging the spine, most commonly with MRI scan.
How is it treated?
The treatment cervical myelopathy is surgical decompression of the spinal cord. This can be achieved either by an operation through the front or back of your neck, removing one or more discs, or part of the vertebral bones to create the room the spinal cord needs. Metal plates and cages may be needed to support your neck on the inside, once the decompression has been performed, so that the neck remains stable and safe. The metal implants would normally stay in forever and would not need to be removed.
The main purpose of performing surgery is to prevent further nerve damage and weakness occurring and to retain muscle and nerve function levels. After surgery, of course one also hopes to see measurable improvement in this function, but due to nerve damage that has already occurred, complete recovery can never be guaranteed.
Timing of surgery is important. Rapidly progressive symptoms, need early surgery. Sometimes, very mild symptoms are treated non-operatively, with regular outpatient visits to assess progression.