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Definition

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 Spine

Cervical Spine
© 2009 Nucleus Medical Media, Inc.

Causes

Cervical myelopathy is caused by:

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Risk Factors

These factors increase your chance of developing this condition:

  • Infections
  • 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.

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Symptoms

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
  • Dizziness
  • 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)

Diagnosis

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:

  • Reflexes
  • Vision
  • 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

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Treatment

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

Surgery

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

Cervical Fusion

Sagittal View of a Cervical Fusion
Screws and a plate prevent the vertebrae from putting pressure on the spinal cord.
© 2009 Nucleus Medical Media, Inc.

Nonsurgical Approaches

Your doctor may recommend that you do:

  • Physical therapy
  • Occupational therapy
  • Other approaches, such as ultrasound therapy, heat therapy, electrical stimulation

Medication

Your doctor may prescribe:

  • Non-steroidal anti-inflammatory drugs (NSAIDS)
  • Corticosteroids

Prevention

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.