Cervical Myelopathy

Cervical Myelopathy is a medical term that refers to a condition where there is compression or damage to the spinal cord in the cervical spine due to aging. Cervical Myelopathy is a serious condition that can lead to a range of neurological symptoms and, if untreated, can cause permanent disability. The most common causes of cervical myelopathy include degenerative changes in the spine, trauma, tumors, and inflammatory diseases. It can also be caused by the hardening of the ligaments that surround the spinal cord.

The symptoms of cervical Myelopathy can include:

• Neck pain can range from mild to severe and may radiate to the shoulders and arms. Chronic neck pain may accompany stiffness and pain radiating to the shoulders and arms.
• Neurological deficits: Numbness or tingling in the arms and hands, and sometimes the legs and feet. Pain and/or weakness in the fingers, arms, feet, and legs.
• Impaired fine motor skills: Difficulty with tasks that require manual dexterity, such as buttoning a shirt or writing. Hand clumsiness or loss of coordination.
• Gait disturbances: Difficulty walking, an unsteady gait, loss of balance and coordination.
• Loss of Bladder or Bowel Control: In severe cases, issues with bladder and bowel function might occur.

The most common cause of cervical myelopathy are degenerative conditions, such as:

• Osteoarthritis and bone spurs
• Degenerative disc disease – wear and tear of the intervertebral discs in the cervical spine.
• Spondylosis – degeneration of the vertebral bodies and intervertebral discs in the spine.
• Herniated discs – a condition in which the gel-like center of a spinal disc bulges out and puts pressure on the spinal cord.
• Spinal stenosis – Spinal canal narrowing can occur due to disc herniation, bone spurs, and thickening of the ligaments within the spine. This narrowing reduces the space available for the spinal cord, leading to compression.

Rheumatoid arthritis

Rheumatoid arthritis can cause inflammation and lead to instability or compression in the cervical spine.

Spinal cord tumors

Both benign and malignant spinal cord tumors can grow within the spinal canal or vertebrae, compressing the spinal cord.

Traumatic spinal cord injuries

Traumatic spinal cord injuries such as whiplash and other spinal cord trauma. Injuries such as fractures or dislocations of the cervical spine can directly compress or damage the spinal cord.

Spinal cord infections

e.g., meningitis, transverse myelitis

Minimally invasive spine surgeon Dr. Mathew Cyriac will review your medical history and inquire about your symptoms and their onset. He will perform a physical examination and a neurological exam. Dr. Cyriac will look for signs indicating spinal cord involvement during the neurological examination. Some of these signs include:

• Increased Reflexes: When the doctor taps on certain tendons, the reflex response may be stronger or more exaggerated than normal. This is known as hyperreflexia.
• Babinski Sign: The doctor may run a tool along the bottom of the foot. Sometimes, the big toe moves upward instead of downward, which is an unusual response.
• Muscle Spasms or Jerking Movements: The patient might experience involuntary, repeated muscle contractions, known as clonus, usually in the ankle or knee.

Dr. Cyriac will order imaging studies, including X-rays and an MRI, to view the soft tissues, including the cord and discs. An MRI is imperative to evaluate the spine and spinal conditions.

Early detection and treatment of cervical myelopathy is vital to prevent permanent neurological impairment. If you experience symptoms such as persistent neck pain, numbness or tingling in the arms or hands, or difficulty with balance, it is essential to seek medical evaluation promptly. An early diagnosis can lead to more effective management and a better overall outcome.