What Is Cervical Myelopathy?
Cervical myelopathy is a condition where there is compression of the spinal cord in the neck area. The spinal cord acts as a pathway for information that goes between the brain and the body. Thus, the pressure that results can affect the function of the legs, hands, and even bladder. Myelopathy meaning: It is the disease of the spinal cord itself. The cervical compressive myelopathy is myelopathy when its origin is from the neck. It usually occurs gradually due to degeneration of the bones, disks, and ligaments of the neck, and is most frequently related to cervical spondylosis. People generally become aware of the presence of clumsy hands or stiff walking patterns. The Spine eXpert Clinic in Mumbai has Dr. Zahir Abbas Merchant as the spine specialist who deals with this disorder after 15 years of orthopedic experience.
Cervical Myelopathy Symptoms
These cervical myelopathy symptoms may be mild at first but eventually become more serious. It is important to recognize these symptoms as early as possible.
Symptoms in the neck
- Stiffness of the neck, decreased movement
- Constant neck pain that fails to go away by resting
- Pain/tightness between the shoulder blades
Symptoms in the hands, legs and body
- Tingling or numb hands
- Difficulty buttoning up clothes, writing and manipulating objects
- Weakness or heaviness of the legs and an unsteady gait
- Sense of imbalance
- Sensation of electric shock down the back upon bending of the neck
- Urinary and fecal incontinence in the late stages of the disease
The above are some of the spinal cord compression symptoms. If you have any of these symptoms, do not delay.
Myelopathy vs Radiculopathy
Comparison between myelopathy vs radiculopathy is a common confusion. Both can originate in the cervical region but affect different areas. When radiculopathy occurs, there is pressure on one nerve root, due to cervical disc herniation. This leads to pain, numbness, or weakness in one arm. When myelopathy occurs, there is pressure on the spine, and therefore, the signs are much more generalized. There may be symptoms in both arms and legs, balance problems, and pain that can even be mild. Loss of function is associated with myelopathy. Because myelopathy can cause complications if not identified, it must be diagnosed in a more efficient manner.
What Causes Cervical Myelopathy?
The majority of cases are due to degeneration with age of the neck region. The most common reasons include:
- Cervical spondylosis, which means that the discs dehydrate and bone spurs develop
- Bulging or herniated discs putting pressure on the cord
- Enlargement of the ligament within the spinal canal
- Narrowing of the spinal canal
- Trauma, dislocation of bones, and tumors or infections rarely
In combination, they result in cervical vertebrae compression and cervical cord compression. Spending a lot of time with bad posture of the neck and prior neck injuries can worsen the situation.
Cervical Stenosis and Myelopathy
The term for spinal canal narrowing in the cervical area is cervical stenosis. With the reduction in size, the cord will lack enough space to fit into and thus get squeezed. This explains why cervical spondylotic myelopathy is the commonest type. This condition may occur further down in the spine as well, and stenosis in the lower back results in leg pain and problems with walking in a different manner. However, stenosis in the neck affects the cord itself, and hence, its consequences are more serious. The narrowed canal may remain asymptomatic for many years until there is a slight disc bulge or a simple fall.
Understanding Your MRI Report: What Myelomalacia Means
Many patients experience anxiety any time the term “myelomalacia” is mentioned in their MRI results. The myelomalacia meaning is the softening or injury within the spinal cord, most commonly following a lengthy period of compression or pressure. Myelomalacia shows up on the MRI as a bright area within the spinal cord, and this indicates that there has been a period of strain or injury to the spinal cord. This does not necessarily mean that the damage is irreversible or that the surgery will not be successful. However, it does indicate action needs to be taken without further delay.
Cervical Myelopathy Treatment
The majority of cases are due to degeneration with age of the neck region. The most common reasons include:
- Cervical spondylosis, which means that the discs dehydrate and bone spurs develop
- Bulging or herniated discs putting pressure on the cord
- Enlargement of the ligament within the spinal canal
- Narrowing of the spinal canal
- Trauma, dislocation of bones, and tumors or infections rarely
In combination, they result in cervical vertebrae compression and cervical cord compression. Spending a lot of time with bad posture of the neck and prior neck injuries can worsen the situation.
The majority of cases are due to degeneration with age of the neck region. The most common reasons include:
- Cervical spondylosis, which means that the discs dehydrate and bone spurs develop
- Bulging or herniated discs putting pressure on the cord
- Enlargement of the ligament within the spinal canal
- Narrowing of the spinal canal
- Trauma, dislocation of bones, and tumors or infections rarely
In combination, they result in cervical vertebrae compression and cervical cord compression. Spending a lot of time with bad posture of the neck and prior neck injuries can worsen the situation.
Cervical Myelopathy Treatment is based on how bad the compression is and how quickly the symptoms are developing.
Non-surgical care
Medicines, physiotherapy, and the use of a neck brace will relieve pain and stiffness. However, it should be noted that this treatment does not eliminate pressure from the cord. This treatment method may be appropriate for cases of a very mild degree, but only under strict observation with frequent check-ups and scans.
Surgery
Decompression is the key method. The aim is to relieve pressure on the cord and prevent further progression of the disease. Typical procedures include:
- ACDF: the affected disc is surgically removed from the front and fused with bones
- ACCF: a damaged vertebra is removed along with parts of discs and restored
- Laminectomy: the bone is opened at the back part in order to create space for the cord
Early surgery tends to yield good results. The Spine eXpert Clinic doctor, Dr. Zahir Abbas Merchant, will help you choose the right operation.
Dorsal and Thoracic Myelopathy
Myelopathy can be seen in the middle back region also. The dorsal or thoracic myelopathy is not as common, but it works by the same principle of the spinal cord being compressed. It can lead to lower extremity weakness, gait disturbances, trunk and bladder problems. The causes are related to disk issues, bone spur, thick ligament, trauma and tumors. Treatment is also decompression when the symptoms are increasing.
When to See a Spine Doctor
Make an appointment to see a specialist who treats spines as soon as possible if you experience numbness or clumsy hands, difficulty in walking, tendency to fall, or neck pain with weakness. In case there are any changes in bladder and bowel control, get help immediately. One doesn’t have to experience pain to get medical help. Early diagnosis at The Spine eXpert Clinic will protect your spinal cord.