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.
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Factors that may increase your risk of cervical myelopathy include: InfectionsIschemia—restriction of blood supply
Autoimmune disorders, such as
multiple sclerosis, neuromyelitis optica; or other conditions, such as vascular disease or degenerative disease
History of bone or back problemsBeing born with a narrow spinal canalJob or sport involving regular stretching and straining of spineHistory of cancer involving the bones
Symptoms may include: Pain in the shoulder and armsTingling or numbness in the arms and legsTrouble walking or balancingMuscle weaknessProblems flexing the neckLightheadednessProblems with fine motor control, such as buttoning a shirtIrregular movementsBowel or bladder problemsWeakness below the waist or in all 4 limbs
You will be asked about your symptoms and medical history. A physical exam will be done. It will focus on any muscle weakness. A neurological exam may also be done to check your: ReflexesVisionMental state
Imaging tests evaluate the spine and surrounding structures. These may include: X-rayMRI scan
Other tests may include: Electromyography
Somatosensory evoked potentialsVisual evoked potential test (VEP)
Talk with your doctor about the best treatment plan for you. This may involve: Treating the cause of the myelopathyImproving functions that you have lostReducing or managing painDoing strengthening exercisesTeaching you ways to reduce injuriesHelping 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 lasting injury. There are many different kinds of surgery and procedures to stabilize the neck, such as: Discectomy—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
Screws and a plate prevent the vertebrae from putting pressure on the spinal cord.
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Nonsurgical approaches may include: Physical therapyOccupational therapyOther approaches, such as ultrasound therapy, heat therapy, or electrical stimulationPlasmapheresis
Medications may help to relieve symptoms. Common medications include: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofenCorticosteroidsRituximab—This is an antibody used to treat some autoimmune disorders.
Other medications that affect the immune system are also sometimes used.
It is difficult to prevent this condition. Follow these guidelines to prevent accidents and strains: Ask about ergonomics in your workplace. Some examples of ergonomics include learning correct lifting techniques, improving your posture, and sitting correctly.Avoid contact sports if you have had disc 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 the stairs and your bed.Install handrails in the tub and shower.Rise slowly from a seated or lying position.
Cervical myelopathy. Johns Hopkins Medicine website. Available at:
http://www.hopkinsmedicine.org/neurology_neurosurgery/specialty_areas/spine/conditions/cervical_myelopathy.html. Accessed November 20, 2014.
Older adult falls. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/homeandrecreationalsafety/falls/index.html. Accessed November 20, 2014.
Pollard H, Hansen L, Hoskins W. Cervical stenosis in a professional rugby league football player: a case report.
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Young WB. Clinical diagnosis of myelopathy.
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Young WF. Cervical spondylotic myelopathy: a common cause of spinal cord dysfunction in older persons. Am Fam Physician. 2000;62(5):1064-1070.
Last reviewed November 2015 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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