Cervical Myelopathy

What is Cervical Myelopathy?

Cervical myelopathy is a condition that often goes unrecognized by patients until they become very symptomatic because it can sometimes be very slow in onset and progress over years. The term “myelopathy” refers to dysfunction of the spinal cord (the main nerve bundle that travels from the brain and controls your arms and legs). The most common reason for this to occur is what spine surgeons call cervical spondylotic myelopathy (CSM), which refers to dysfunction of the spinal cord as a result of spinal cord compression (pressure on the spinal cord itself). Many patients often first present to their primary care physicians or a neurologist, unaware that the symptoms are from the neck / spine.

What symptoms do patients develop?

Patients with myelopathy often endorse some or all of the following symptoms:

• Numbness or tingling in the arms or hands
• Difficulty with fine motor skills (clasping jewelry, buttoning a shirt, picking up small objections)
• Clumsiness / poor coordination
• Dropping objections / difficulty with grip
• Pain radiating into the shoulders, arms, hands
• Weakness in the arms or hands
• Neck pain
• Worsening balance

What causes Cervical Myelopathy

• Age-related degeneration, called spondylosis (arthritis) in the neck which can slowly narrow the space available for the spinal cord, causing cervical stenosis
• Disc Herniations
• Congenital Stenosis (patients born with narrow spinal canal)
• Trauma / Fractures

What is the natural history of Cervical Myelopathy?

Cervical myelopathy does tend to progress in most patients, with worsening symptoms over time. This is why it is important to get a thorough evaluation by Dr. Bronson to determine the best treatment options for you.

What are the treatment options?

Dr. Bronson is an expert in the treatment of cervical myelopathy. Sometimes patients can be monitored over time or managed non-operatively with:

• Physical therapy
• Pain medications (NSAIDS, steroids, etc)
• Epidural Injections

For patients requiring myelopathy surgery, Dr. Bronson is trained in many different modern techniques. These can include minimally invasive spine surgery and motion preserving cervical spine surgery in many cases. Some options include:

• Cervical Laminoplasty
• Cervical Disc Arthroplasty / Disc Replacement
• Anterior Cervical Discectomy and Fusion (ACDF)
• Posterior Cervical Laminectomy and Posterior Cervical Fusion