Cervical Myelopathy

Cervical myelopathy refers to the compression of the spinal cord in the neck. The spinal cord acts as a central communication hub, transmitting signals between the brain and the rest of the body. When the spinal cord is compressed, it disrupts these signals, resulting in various impairments. The condition often progresses gradually, and if left untreated, it can lead to permanent damage.

The symptoms of cervical myelopathy can vary widely, depending on the severity of spinal cord compression and the specific area affected. Common signs and symptoms include:

1. Neck Pain and Stiffness: Persistent discomfort or stiffness in the neck region is often an early indicator.
2. Numbness and Tingling: Patients may experience a “pins and needles” sensation in their arms, hands, or legs.
3. Weakness in Limbs: Gradual weakening of the arms and legs can interfere with activities such as gripping objects or walking.
4. Loss of Fine Motor Skills: Tasks requiring precise hand movements, such as buttoning a shirt or writing, may become challenging.
5. Gait Disturbance: Difficulty walking, characterized by imbalance or an unsteady gait, is a hallmark symptom.
6. Coordination Problems: Impaired coordination can affect daily activities and increase the risk of falls.
7. Bowel and Bladder Dysfunction: In severe cases, patients may experience loss of control over bowel or bladder functions.

These symptoms often progress slowly, but any sudden worsening of neurological symptoms should be addressed immediately. Early treatment can make a big difference.

Cervical myelopathy happens when something puts pressure on the spinal cord. The most common causes include:

Age-Related Changes

• Cervical Spondylosis: Age-related wear and tear of the cervical spine can lead to bone spurs (osteophytes), bulging discs, and thickened ligaments, all of which contribute to a narrowing of the space around the spinal cord.
• Facet Joint Arthropathy: Degeneration of the facet joints in the cervical spine can narrow the spinal canal and place pressure on the spinal cord.

Trauma

Spinal injuries resulting from accidents, falls, or sports can cause bone fractures or damage spinal discs in the neck leading to spinal cord compression.

Congenital Conditions

Some people are born with a narrow spinal canal (spinal stenosis), making them more likely to develop myelopathy.

Rheumatoid Arthritis

Chronic inflammation associated with rheumatoid arthritis can lead to instability in the cervical spine and contribute to spinal cord compression.

Tumors and Infections

Growth of tumors or infections in the cervical spine are less common but can lead to mechanical compression or inflammatory damage to the spinal cord.

Thickening of a ligament located at the back of the spinal column

The abnormal thickening of this ligament often causes compression of the spinal cord causing pain and symptoms.  This is often associated with aging and degenerative changes in the spine, but genetics can play a role.

Early diagnosis of cervical myelopathy is essential to prevent irreversible spinal cord damage. Dr. Lauren Boden emphasizes the importance of a thorough clinical evaluation and advanced imaging techniques to accurately diagnose the condition.

Medical History

Dr. Boden will ask about your medical history and what you’ve been experiencing, like pain, weakness, or numbness. These details help guide the diagnosis.

Physical and Neurological Exam

This evaluation includes testing muscle strength, balance, sensation, and reflexes. This helps pinpoint which areas of your body are affected.

Imaging Tests

• X-rays: X-rays of the cervical spine can reveal degenerative changes, alignment issues, or fractures.
• Magnetic Resonance Imaging (MRI): MRI is the gold standard for diagnosing cervical myelopathy. It provides detailed images of the spinal cord, nerves, and surrounding structures, highlighting areas of compression.
• Computed Tomography (CT): CT scans are useful for assessing bone abnormalities and spinal canal narrowing.

Motion X-rays

These specialized X-rays are taken while you move your neck to assess the stability of the cervical spine and can identify if certain parts of your spine are unstable.

Cervical myelopathy can get worse over time if left untreated. Without care, it can lead to permanent issues with walking, balance, or even using your hands. The sooner it’s diagnosed, the better your chances of slowing or stopping the progression.