Sciatica/ Disc Herniation
Overview
Cervical myelopathy is a clinical condition that involves compression of the spinal cord in the cervical spine (neck). The cervical spine comprises 7 vertebrae, with 6 intervertebral discs and 8 nerve roots. The spinal cord travels inside the vertebral column that is constructed with vertebrae in the front, cushioned by intervertebral discs, and facet joints and lamina at the back. The branched nerve roots primarily control the function of the shoulders, arms and hands. Any excessive pressure on the spinal cord can cause a decrease in its functioning.
Causes
- Age-related changes, causing compression of the spinal cord from disc/ facets/ ligametum flavum hypertrophy
- Trauma to cervical spine: whiplash injury.
- Cancers
- Cervical spine deformity
Symptoms
The symptoms of cervical myelopathy may appear in the neck or may be felt elsewhere in the body
Neck symptoms include:
- Pain
- Stiffness
- Reduced range of motion
With the progression of the condition, you may experience a shooting pain that originates in the neck and travels down the spine.
Other symptoms include:
- Weakness in the arms and hands
- Numbness or tingling in the arms and hands
- Clumsiness and poor coordination of the hands
- Difficulty handling small objects
- Difficulty in maintaining balance
Diagnosis
Early detection of cervical myelopathy helps in effective treatment. To diagnose the condition, your doctor may:
- Conduct a physical exam and measure muscle strength and reflexes.
- Advise further tests, including an MRI scan, an X-ray or a CT myelogram of the neck.
- Perform electrical tests to check communication between the nerves in your arms & hands and your brain through the spinal cord.
Treatment
To treat cervical myelopathy, while there are non-surgical options such as physical therapy and cervical collar brace, surgery is often necessary to eliminate the compression of the spinal cord and prevent deterioration of the condition.
The surgical procedures include widening of the spinal canal (laminoplasty) and spine decompression surgery with spinal fusion, which helps stabilize the spine after herniated discs, bone spurs or ossified ligaments are fully or partially removed.
Based on your condition, your doctor may recommend the surgery to be performed from the back of the neck (posteriorly) or from the front of the neck (anteriorly).