Cervical myelopathy: a progressive condition that begins in the neck
This condition tends to strike as we get older, but it can be treated with surgery.
Cervical myelopathy is a common but somewhat mysterious condition – mysterious because many people don’t realize they have it. Rather, they assume its symptoms are just things that happen as we age.
Cervical myelopathy refers to damage or dysfunction of the spinal cord in the neck (the “cervical” part of the spine) due to compression. Cervical myelopathy gets worse over time. Its symptoms can interfere with basic tasks. However, this condition is treatable in most cases. Byron Stephens II., M.D., a Vanderbilt Spine Center specialist with Vanderbilt Orthopaedics, answers some basic questions about cervical myelopathy:
What are the symptoms of this condition?
Fortunately, this condition is not usually painful. However, people with cervical myelopathy typically start having trouble with fine motor control. For example, their handwriting gets shaky, or they drop things easily, or they have difficulty opening jars. Having trouble with balance is another symptom, Stephens said: “They feel like they’re wobbly on their feet.”
Usually they do not realize that those symptoms are due to a problem in the neck, because they don’t feel pain or other symptoms in the neck. Later, after the condition has progressed, some people experience weakness or numbness, especially in their hands.
“A lot of people chalk it up to old age,” Stephens said. “That’s the thing – it’s often missed, because it can be very insidious but also progressive.”
Each patient’s progression is different. Cervical myelopathy typically takes years to develop, which is another reason why it can go undiagnosed for a long time.
How is cervical myelopathy diagnosed?
The symptoms are a strong clue. People with these symptoms typically first talk to their primary care doctors to find out why they’re losing dexterity in their hands or feel unsteady. Usually, it’s an MRI (magnetic resonance imaging) scan that reveals that the spinal cord is being pinched in the neck.
Is this something very rare?
No, plenty of people experience cervical myopathy in their older years, meaning from their 60s and older. There are an estimated 200,000 people diagnosed with it every year in the United States.
How is cervical myelopathy treated?
Unfortunately, this problem can’t be solved with medication or physical therapy. Mild cases can be observed, but most people with cervical myelopathy that’s causing symptoms require surgery. The surgical techniques vary depending on the details of a patient’s condition, but operations often involve fusing vertebrae in the neck, or replacing the cartilage disc between vertebrae. Recovery time depends on which type of surgery is done, with at least six weeks’ recovery time.
If you are dealing with an injury, facing surgery or coping with chronic pain, Vanderbilt Orthopaedics offers a full spectrum of care. Our specialists work with you from evaluation and “prehab” through physical therapy and, if needed, surgery. We’ll help you get back to doing the things you love, pain-free. To make an appointment, call 615-936-7846.