Cervical myelopathy describes myelopathy in which the spinal cord is compressed inside the cervical spine (neck). Cervical myelopathy is a frequent and debilitating condition, yet there is no agreement on the best cure. Re-operation is required in up to 25% of patients who experience symptom resurgence. Adults and the elderly are the most commonly affected by cervical myelopathy.
The most prevalent symptoms are symmetric numbing and tingle in the extremity, hand awkwardness, and gait instability in elderly patients. Because the illness progresses in stages, the most common therapy made by cervical myelopathy specialists is surgical decompression and stability.
Common symptoms of cervical myelopathy
Cervical myelopathy manifests itself in two ways: symptoms felt in the neck and symptoms felt elsewhere in the body near or below the compressed portion of the spinal cord.
The symptoms positioned in the neck can be:
- Minimized range of motion
- Pain in neck
Intense pain that begins in the neck and proceeds down the spine may be experienced as the condition advances.
The symptoms included can be:
- Numbness or tingling sensation in arms or hands
- Weakness, clumsiness, and poor coordination of hands
- Poor balance
Cervical spondylosis myelopathy
Cervical spondylotic myelopathy is a prevalent kind of cervical myelopathy. The phrase “spondylotic” relates to a few of the potential causes of myelopathy, which is the slow deterioration of the spine as you become older. As a result, adults over 50 are more likely to develop cervical spondylotic myelopathy.
Cervical spinal stenosis, or constriction of the spinal canal inside the neck, is a common symptom of progressive spine degeneration. Some persons are birthed with just a narrow spinal canal, and if the canal narrows further, they may develop myelopathy sooner than others. Additional forms of spine degeneration that could stress the spinal cord and induce myelopathy include bulging or ruptured discs and skeletal spurs in the neck.
Main causes of cervical myelopathy
Cervical myelopathy could be induced by ossification (hardening) of such ligaments enveloping the spinal cord, such as with the posterior aspect ligaments and ligamentum flavum, in addition to progressive stress and strain of the spine.
The ossification of said posterior longitudinal ligament (OPLL) is the most popular type of ossification. It implies that perhaps the soft tissue that links the spine’s bone loses flexibility and gradually transforms to bone (ossification). As the ligament thickens, it begins to take up more room and exert stress on the spinal cord, resulting in myelopathy. The most prevalent site of OPLL ossification would be in the neck region of the spine.
Diagnosis of cervical myelopathy
A proper diagnosis by cervical myelopathy specialists is requisite for proper treatment. The symptoms are not unique and are deemed normal symptoms when a person is aging. The process of diagnosis includes:
- Assess your muscle strength as well as reflexes through a physical examination.
- Additional diagnostics, such as an MRI scan, an X-ray, or a CT myelogram of the neck, should be performed.
- Perform electrical examines to see how well your arms and hands’ nerves connect with your brain via the spinal cord.
Cervical myelopathy can be treated with various surgical techniques that your doctor might suggest. Spinal canal enlargement (laminoplasty) could be a useful motion-saving option for certain patients. Others could recover from spine decompression operation combined with spinal surgery, intended to stabilize the spine once herniated discs, bone spurs, or ossified ligament have been excised completely or partly.
These procedures can be done first from the back of the neck (posteriorly) or the front of the neck (anteriorly). Your cervical myelopathy specialists would propose a specific surgical method depending on your condition.