Definition
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.
| Cervical Spine |
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Causes
This problem may be caused by:
- A slipped disc
- Worn cervical discs
- Tumors inside the spinal cord or pushing on the spinal cord
- Bone spurs
- Dislocation or fracture of the neck
- Traumatic injury to the cervical spine
- Problems with the immune system, such as transverse myelitis, multiple sclerosis , or neuromyelitis optica
Risk Factors
Things that may raise the risk of this problem are:
- Infections
- Poor blood supply
- Problems with the immune system, such as rheumatoid arthritis , multiple sclerosis, or neuromyelitis optica
- Vascular disease
- Degenerative disease
- A history of bone or back problems
- History of cancer involving the bones
- Being born with a narrow spinal canal
- Jobs or sports that involve regular stretching and straining of spine
Symptoms
Problems may be:
- Pain in the shoulder and arms
- Tingling or numbness in the arms and legs
- Trouble walking or balancing
- Muscle weakness
- Problems flexing the neck
- Lightheadedness
- Problems with fine motor control, such as buttoning a shirt
- Unusual movements
- Bowel or bladder problems
- Weakness below the waist or in all four limbs
Diagnosis
The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on any muscle weakness. A neurological exam may also be done.
Images may be taken of the spine. This can be done with:
Other tests may be:
- Electromyography (EMG)
- Somatosensory evoked potentials
- Visual evoked potential test (VEP)
Treatment
The cause will need to be treated. Symptoms may be managed with:
- Physical therapy to improve strength, flexibility, and range of motion
- Occupational therapy to help with daily tasks and self-care
- Medicine to ease pain and swelling
Some people may need surgery to ease pressure on the spinal cord. Choices are:
- Discectomy —to remove part of an intervertebral disc that is putting pressure on the spinal cord or nerve root
- Laminectomy —to remove a portion of a vertebra called the lamina
- Fusion of the vertebrae
| Cervical Fusion |
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| Screws and a plate prevent the vertebrae from putting pressure on the spinal cord. |
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RESOURCES
National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov
United Spinal Association http://www.spinalcord.org
CANADIAN RESOURCES
Canadian/American Spinal Research Organizations http://www.csro.com
Health Canada https://www.canada.ca
References
Altaf F, Heran MK, et al. Back pain in children and adolescents. Bone Joint J. 2014 Jun;96-B(6):717-723.
Cervical myelopathy. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/healthlibrary/conditions/adult/orthopaedic%5Fdisorders/CervicalMyelopathy%5F22,CervicalMyelopathy. Accessed January 26, 2021.
Lumbar spondylolysis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/lumbar-spondylolysis. Accessed January 26, 2021.
Older adult falls. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/homeandrecreationalsafety/falls/index.html. Accessed January 26, 2021.
Revision Information
- Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
- Review Date: 12/2020
- Update Date: 01/26/2021