Cervical Myelopathy

Cervical myelopathy is a condition in which the spinal cord in the neck has been compressed over long periods of time, leading to the death of spinal cord cells. Untreated, this condition can cause irreversible severe loss of function and eventual paralysis. Getting an accurate diagnosis early on can relieve symptoms and prevent permanent damage from cervical myelopathy.

  • Symptoms

  • Causes

  • Treatment Options

  • Neck pain, soreness, or stiffness
  • Sometimes there is little or no pain in the neck itself
  • Reduced range of neck motion
  • Audible grinding sound with certain neck movements
  • Nerve pain, including “electric shock” pains into the arms and legs, especially when bending the head forward
  • Symptoms may flare during certain activities or physical movements
  • Weakness, numbness, or tingling in the legs, arms, and hands (bad enough to affect grip)
  • While walking, legs feel heavy and it is difficult to speed up
  • Problems with fine motor function and coordination, including handwriting, typing, buttoning a shirt, holding items without dropping them, etc.
  • Problems with balance, dexterity, and reflexes
  • Other bodily function issues, such as incontinence
  • Symptoms tend to worsen slowly but may go through cycles of remaining stable or rapidly worsening
  • Sometimes irreversible loss of function
  • Sometimes irreversible paralysis

Frequently Asked Questions

What causes cervical myelopathy?

Cervical myelopathy is the result of long-term compression of the spinal cord. If cervical spinal stenosis has caused the bones and/or discs of the neck to compress the spinal cord, it can significantly narrow the spinal column and compress the spinal cord. Prolonged compression can eventually kill spinal cord cells, which can lead to permanent severe loss of function or paralysis.

How can I be sure I have cervical myelopathy and not another health condition?

The symptoms of cervical myelopathy are often misdiagnosed as other conditions, such as carpal tunnel syndrome or peripheral neuropathy. A combination of a detailed medical history, physical examination, MRI, CT scan, X-rays, reflex testing, and other evaluation methods can yield a proper diagnosis.

Which cervical myelopathy treatment is best?

Surgery is usually the only effective treatment for cervical myelopathy, especially for moderate to severe cases. Decompression of the spinal cord is essential to prevent lasting damage. Dr. Pehler will carefully consider your situation before recommending the appropriate spinal decompression surgery to treat cervical myelopathy.

What will the surgery recovery be like?

The details of your recovery will vary depending on the surgical technique chosen. In most cases, patients can return home on the day of the surgery or within 1 to 2 days. A neck collar may be placed to support the spine as it heals; this may need to be worn for up to several weeks depending on the procedure. Typically, some pain and stiffness are common during recovery but will subside as the tissues heal. More details will be provided for you based on your surgical plan.

What are the risks of surgery for cervical myelopathy? 

All surgeries carry some risks. These include but are not limited to reactions to anesthesia, nerve injury, reduced movement, discomfort, failure to alleviate symptoms, temporary voice hoarseness/change, temporary discomfort when swallowing, and others. The risks of nerve injury are incredibly low due to modern techniques and careful monitoring of the patient during the procedure. All potential risks and benefits will be discussed with you in detail when you are evaluated in clinic.

What are the long-term implications of cervical myelopathy?

Cervical myelopathy can have a major impact on quality of life. With cervical myelopathy, compression of the neck has worsened to the point where spinal cord cells have already begun to die. While individuals with cervical myelopathy may go through periods of relative stability, at any point it could rapidly worsen. Without intervention, cervical myelopathy can lead to eventual paralysis and/or irreversible loss of bodily function. If you have any of the symptoms listed above, it is important to see your doctor for an evaluation right away to get an accurate diagnosis and begin your treatment plan.