Cervical myelopathy is a condition caused by compression of the spinal cord in the neck region, which can lead to significant neurological impairments. This compression can arise from various sources, including degenerative changes, trauma, or congenital abnormalities, affecting the transmission of nerve signals between the brain and the body.
Symptoms of Cervical Myelopathy: Common symptoms of cervical myelopathy include neck pain and stiffness, often accompanied by a sensation of unsteadiness or imbalance. Patients may experience tingling, numbness, or weakness in the arms, hands, and fingers. Difficulty with fine motor skills, such as buttoning a shirt, is also typical. More severe cases can lead to problems with coordination, bladder or bowel dysfunction, and significant muscle weakness or spasticity in the legs. Symptoms can vary widely, depending on the degree of spinal cord compression.
Causes of Cervical Myelopathy: The primary causes of cervical myelopathy include age-related degenerative changes, such as cervical spondylosis, where discs lose height and vertebrae develop bone spurs that encroach on the spinal canal. Herniated discs can also compress the spinal cord. Trauma, such as fractures or dislocations, can lead to acute myelopathy. Less commonly, congenital conditions like a narrow spinal canal (spinal stenosis) or inflammatory diseases like rheumatoid arthritis can result in spinal cord compression.
Diagnosis of Cervical Myelopathy: Doctors diagnose cervical myelopathy through a combination of medical history, physical examination, and diagnostic imaging. During the physical exam, they assess muscle strength, reflexes, coordination, and sensory function. Imaging studies such as X-rays, CT scans, and MRIs are crucial for visualizing the extent of spinal cord compression and identifying the underlying cause. MRI is particularly useful for detailing soft tissue changes, including disc herniation and spinal cord pathology.Â
Treatments for Cervical Myelopathy: Treatment for cervical myelopathy typically starts with non-surgical approaches but often progresses to surgery, especially in cases with significant symptoms or functional impairment. Non-surgical treatments include physical therapy to maintain muscle strength and flexibility, pain relief medications, and corticosteroid injections to reduce inflammation. However, these methods primarily address symptoms rather than the underlying cause. Surgical options aim to decompress the spinal cord and stabilize the spine. Procedures like anterior cervical discectomy and fusion (ACDF), posterior cervical laminectomy, or laminoplasty are common. Minimally invasive techniques may be employed to reduce recovery time and surgical risks.
In conclusion, early diagnosis and intervention are crucial in cervical myelopathy to prevent permanent neurological damage. With appropriate treatment, many patients experience significant improvement in symptoms and quality of life.
