What is Cervical Myelopathy?

Myelopathy is any condition that slows down the transmission of nerve signals through the spinal cord. In the case of cervical myelopathy, the spinal cord that passes through the cervical spine (i.e. neck) portion of the spinal cord fails to transmit nerve signals to and from the arms, chest, legs, pelvis, and abdomen as rapidly as it should.

Causes

Anything that damages or impinges on the cervical portion of the spinal cord can lead to a cervical myelopathy. Some possible causes include tumors, trauma, viruses, herniated discs, or autoimmune diseases. The most common cause is a degenerative change due to arthritis.

Degenerative changes that occur with conditions such as arthritis can affect the ligaments, discs, and joints in the spine. These changes put pressure on the spinal cord by compressing it or causing the cord to become narrowed. This narrowing of the cervical spinal cord is called cervical stenosis. When the cervical spine becomes too tight, it compresses the spinal cord. This leads to the symptoms of myelopathy.

Symptoms

The cervical spinal cord carries nerve signals to and from the arms, chest, and legs. When these nerve fibers do not function properly due to cervical stenosis or another condition, a variety of symptoms may result. Potential symptoms include numbness or tingling in the hands or feet, weakness in the arms or legs, leg stiffness, bladder problems, unsteady gait, or burning pain involving the arms or hands.

Some people with cervical myelopathy experience pain in their neck, shoulder, or arms. They may also describe a shock-like sensation when they flex their neck or put their chin on their chest. This is referred to as Lhermitte's phenomenon.

It is important to diagnose and treat cervical myelopathy promptly. Delaying can allow the cervical myelopathy to progress, potentially causing permanent spinal cord injury, paralysis, loss of bowel/bladder function, or a variety of other problems.

Diagnosis

A good clinical exam can usually detect the signs of cervical myelopathy. The examination often includes imaging studies such as MRIs or CT scans of the cervical spine. These studies may reveal a narrowing of the spinal canal in the neck or a compression of the spinal cord, indicating the possibility of cervical myelopathy. Somatosensory evoked potential (or SSEP) studies to measure how fast nerve signals move through the spinal cord may also be used in determining the diagnosis.

Treatment

Most people with cervical myelopathy require surgery to prevent progression and to reduce the risk of permanent spinal cord damage. Surgery for myelopathy involves decompressing the spinal cord in order to relieve pressure and allow the nerves to function normally again. As with any surgery there are risks, but surgical decompression offers satisfactory results in over 95% of cases.

Tom Wascher M.D. will review your imaging studies free of charge or, if needed, provide you with a second opinion. He has performed over 1,800 cervical surgeries during his career and wants to see that you receive the best treatment possible. He is a competent and caring surgeon who has your best interests in mind.