Cervical Myelopathy
Next Steps
Definition
Cervical myelopathy is damage to the part of the spinal cord that is in the neck. The cervical spine begins at the base of the skull. It extends to the first seven vertebrae.
| Cervical Spine |
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Causes
Cervical myelopathy may be caused by:
- A slipped disc
- Worn cervical discs
- Tumors in the spinal cord or pushing on the spinal cord
- Bone spurs
- Dislocation or fracture of the neck
- Traumatic injury to the cervical spine
- Problems with the immune system, such as transverse myelitis, multiple sclerosis(MS), or neuromyelitis optica
Risk Factors
Things that may raise the risk of cervical myelopathy are:
- Infections
- Poor blood supply
- Problems with the immune system, such as rheumatoid arthritis, MS, or neuromyelitis optica
- Vascular disease
- A history of bone or back problems
- History of cancer involving the bones
- Being born with a narrow spinal canal
- Jobs or sports that involve regular stretching and straining of spine
Symptoms
A person with cervical myelopathy may have:
- Pain in the shoulder and arms
- Tingling or numbness in the arms and legs
- Trouble walking or balancing, or have odd movements
- Problems flexing the neck
- Lightheadedness
- Problems with fine motor control, such as buttoning a shirt
- Bowel or bladder problems
- Weakness below the waist or in all four limbs
Diagnosis
The doctor will ask about symptoms and health history. A physical exam will be done. It will focus on any muscle weakness. A neurological exam may also be done.
Images may be taken of the spine. This can be done with:
Other tests the doctor may want done are:
- Electromyography (EMG)
- Somatosensory evoked potentials
- Visual evoked potential test (VEP)
Treatment
The goal of treatment is to ease symptoms. The cause of the cervical myelopathy will need to be treated. Symptoms may be managed with:
- Physical therapy to help with strength, flexibility, and range of motion
- Occupational therapy to help with daily tasks and self-care
- Medicine to ease pain and swelling
Some people may need surgery to ease pressure on the spinal cord. The doctor may advise:
- Discectomy—to remove part of a disc that is putting pressure on the spinal cord or nerve root
- Laminectomy—to remove a part of a vertebra called the lamina
- Fusion of the vertebrae
| Cervical Fusion |
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| Screws and a plate prevent the vertebrae from putting pressure on the spinal cord. |
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Prevention
There are no known ways to prevent cervical myelopathy.
References
- Cervical decompression. University of Rochester Medical Center website. Available at: https://www.urmc.rochester.edu/services/treatments/cervical-decompression.aspx.
- Cervical myelopathy. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/cervical-myelopathy.
- Lumbar spondylolysis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/lumbar-spondylolysis.
- Older adult falls. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/falls/index.html.