Cervical Myelopathy

Anything that reduces the space around your spinal cord can cause myelopathy, such as

• The normal wear and tear of everyday life.
• An Injury to your neck (spinal trauma).
• A disease, such as arthritis.
• A tumor.

Any condition that can cause stenosis may cause myelopathy. Myelopathy is a very serious condition.

Myelopathy actually has a wide range of symptoms, often depending on where the compression happens along your spinal cord. When affecting the cervical spine, you may experience pain, numbness, weakness, or tingling, and have problems such as

• Difficulty with Walking
• Weakness in the Lower Extremities
• Loss of Balance
• Loss of Coordination in the Arms, Hands, or Legs
• Dexterity Problems
• Handwriting Deterioration
• Loss of Fine Motor Skills (e.g., picking up coins, buttoning shirts)

Exaggerated reflexes may also occur, resulting in the compromised smooth function of muscles in the arms or legs.

During your consultation, Dr. Ball will conduct a physical exam and measure your muscle strength and reflexes. He may also

• Order imaging tests, including an MRI scan, an X-ray, or a CT myelogram of your neck.
• Conduct electrical tests to measure how well the nerves in your arms and hand communicate with your brain through the spinal cord.

An MRI scan is the most conclusive test for diagnosing myelopathy, as the pressure on the spinal cord may cause nerve cell death and changes in the appearance of the spinal cord on MRI studies.

Treatment options depend on your symptoms. You may benefit from nonsurgical treatment options such as physical therapy or a cervical collar brace; however, to eliminate compression of the spinal cord and to prevent worsening of the condition, surgery is often warranted.

If a closely monitored period of nonsurgical treatment does not alleviate cervical myelopathy symptoms, surgery may be recommended.

Since myelopathy is considered a progressive disease resulting in irreversible damage of the spinal cord, it is considered a surgical disorder. Failure to properly treat this condition may result in paralysis and loss of function in both arms and both legs, also known as quadriplegia. Severe myelopathy may thus be treated with a cervical laminoplasty or laminectomy with or without fusion. During a laminoplasty, Dr. Ball creates more space for the spinal cord and nerve roots to relieve the painful pressure of spinal stenosis, a narrowing of the spinal canal that can result from arthritis.

On occasion, the complete removal of the vertebral body, or corpectomy, in conjunction with fusion is a necessary part of the decompression to relieve pressure on the spinal cord and the spinal nerves. It involves the removal of bone and discs from your cervical spine, followed by a fusion using a bone graft or implant (cage) to stabilize the spine.

Surgery can take 1-2 hours, and sometimes 3 or more depending on how many discs will be removed, how badly the discs or vertebrae are diseased, and other factors. During your consultation, Dr. Ball will discuss these details with you.

After surgery, you can expect your neck to feel stiff or sore. You may also find it difficult to sit or stand in one position for very long and you may need pain medicine.

If you have a cervical fusion, you will be given a neck brace to wear after surgery. Dr. Ball will let you know how long you will need to wear it.

Typically, it may take patients up to 4 to 6 weeks to recover and get back to normal activities, but it may take 3 to 6 months for a full recovery.

Dr. Hieu Ball has 20 years of experience specializing in the treatment of spinal disorders of adult and pediatric patients. His practice includes caring for congenital, scoliosis, trauma/fracture care, degenerative disc disease, disc herniations, spinal stenosis, work-related injuries, and complex revision surgery. If you would like to schedule an appointment with Dr. Ball, please call our office at (925) 667-3745. You may also request an appointment online.