Cervical myelopathy is a condition that occurs due to compression of the spinal cord in the neck.
The most common cause of cervical myelopathy is a disc prolapse of a significant degree. This results in compression and injury to the spinal cord. A lesion within the cervical spine can potentially compress the spinal cord, and cause myelopathy. Cervical myelopathy varies as in intensity as per the severity of compression in the spinal cord and also on the location of the compression.
It is better to diagnose cervical myelopathy earlier to make the treatment successful. Cervical myelopathy has symptoms similar to ageing. As such, it can sometime be mistaken as symptoms of ageing such as development of weakness, difficulty with walking, change in bowel and bladder habits for example. For diagnosis of cervical myelopathy, the surgeon will conduct the following
A patient usually experiences the following symptoms:
Usually, the symptoms come on gradually. Symptoms can reappear at any time later on also. It is a condition that needs urgent evaluation and treatment. This is due to the potential of causing worsening and permanent cervical cord damage. Patients who have had this condition for a long period of time might also have a very spastic gait and associated muscle loss.
The recommended treatment for this condition is surgical treatment. The options for surgery are guided by the extent of spinal cord compression. The deposition of bony material in the disk is another consideration factor.
The usual operative approaches that are followed are a cervical discectomy and fusion. When the area of compression is over a longer segment, there might be a need to remove vertebral segments. This procedure is called a vertebrectomy. Posterior decompression with laminectomy or laminoplasty .
The decision of anterior versus posterior surgery is taken by the surgeon after considering multiple clinical, radiological and patient factors. The aim of all surgical options is to achieve decompression of the spinal cord, without affecting the stability of the spine.
Other adjuncts in the treatment of cervical myelopathy include physical therapy and use of a cervical collar brace. Physical therapy helps the pain, prevents neurological deterioration and improves neurological deficit. Physical therapy includes aerobic exercise, improving posture, dynamic upper and lower limb exercise and cervical stabilisation exercises.
Generally, cervical myelopathy is caused due to the wear and tear in the spine. Besides this, there can be other causes such as the hardening of the ligament around the spinal cord. Some other causes of cervical myelopathy include:
Multiple risk factors can lead to cervical myelopathy, some of which are listed below:
Cervical myelopathy can lead to long term and permanent damages, if the compression is severe. The condition can cause disabilities in patients, wherein the patient might not be able to move much and would be wheelchair bound.
Some activities such as jumping, lifting heavy weights, running and strenuous exercises are to be avoided. These can make the condition worse for a patient.