Pronounced: SIR-veh-cal My-eh-LOP-ah-thee
Cervical myelopathy is damage to the spinal cord. The cervical spine begins at the base of the skull. It extends to the first seven vertebrae. There can be a block of the signals between the brain and the body. Motor and sensory functions may be affected.
Cervical myelopathy is caused by:
These factors increase your chance of developing this condition:
- Ischemia (restriction of blood supply)
- Autoimmune disorders (eg, rheumatoid arthritis]]>, ]]>multiple sclerosis]]>, neuromyelitis optica) or other conditions (eg, vascular disease, degenerative disease)
- History of bone or back problems
- Being born with a narrow spinal canal
- Job or sport involving regular stretching and straining of spine
Tell your doctor if you have any of these risk factors.
If you have any of these symptoms, do not assume it is due to cervical myelopathy. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
- Pain in shoulder and arms
- Tingling or numbness in arms and legs
- Trouble walking or balancing
- Muscle weakness
- Problems flexing neck
- Problems with fine motor control (eg, buttoning a shirt)
- Spastic movements
- Bowel or bladder problems
- Weakness below waist or in all four limbs (in severe cases)
Your doctor will ask about your symptoms and medical history. She will also do a physical exam, focusing on any muscle weakness. In addition, a neurological exam may be done, which assesses:
- Mental state
Tests may include:
- X-ray]]>—a test that uses radiation to take a picture of structures inside the body, especially bones
- ]]>MRI scan]]>—a test that uses magnetic waves to make pictures of structures inside the body, including the spinal cord
- CT ]]>myelogram]]>—imaging test that uses a special dye to view the spinal cord and the area surrounding it
- ]]>Electromyography]]> (EMG)—a test that measures the electrical activity that muscles generate at rest and in response to muscle contraction
- Somatosensory evoked potentials—a test that evaluates conduction of the nerves in the spinal cord
Talk with your doctor about the best treatment plan for you. This may involve:
- Treating the underlying cause of the myelopathy
- Restoring functions that you have lost
- Reducing or managing pain
- Doing strengthening exercises
- Teaching you ways to reduce injuries
- Helping you learn ways to cope with the condition
If there is structural pressure on the spinal cord, you may need surgery right away. This is to attempt to avoid permanent injury. There are many different kinds of surgery and procedures to stabilize the neck, such as:
- Diskectomy]]>—a surgical procedure to remove part of an intervertebral disc that is putting pressure on the spinal cord or nerve root
- ]]>Laminectomy]]>—a surgical procedure to remove a portion of a vertebra, called the lamina
- Fusion of the vertebrae
Your doctor may recommend that you do:
- Physical therapy
- Occupational therapy
- Other approaches, such as ultrasound therapy, heat therapy, electrical stimulation
Your doctor may prescribe:
- Non-steroidal anti-inflammatory drugs (NSAIDS)
While it is difficult to prevent this condition, following these guidelines can help to prevent accidents and strains:
- At work, ask about ergonomics. A consultant can assess how you work. Some examples include learning correct lifting techniques, improving your posture, and sitting correctly.
- Avoid contact sports if you have had disk disease with compression of the spinal cord.
- Limit neck movement.
Take these measures to prevent falls:
- Remove throw rugs and other obstacles from the floor.
- Install a night-light near stairs and bed.
- Install handrails in tub and shower.
- Rise slowly from a sitting or lying position.
National Institute of Neurological Disorders and Stroke
National Spinal Cord Injury Association
Canadian & American Spinal Research Organization
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Young WF. Cervical spondylotic myelopathy: a common cause of spinal cord dysfunction in older persons. American Family Physician website. Available at: http://www.aafp.org/afp/20000901/1064.html . Published September 2000. Accessed November 20, 2008.
Last reviewed November 2009 by ]]> Rimas Lukas, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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