Cervical Myelopathy

Cervical myelopathy is a serious condition affecting the cervical spine, and if left untreated, it can lead to significant and permanent nerve damage, including paralysis and death. In most cases, this is an urgent surgical condition. 

At CalSpine MD, we provide effective treatment options to manage cervical myelopathy and prevent further neurological decline. Our provider, Dr. Hieu Ball, specializes in advanced surgical techniques, including minimally invasive procedures.

Myelopathy describes any neurologic symptoms related to dysfunction of the spinal cord. Cervical myelopathy is frequently caused by compression of the spinal cord in the neck (cervical spine) due to stenosis (narrowing of the spinal canal in the neck) that creates pressure on the spinal cord. 

Cervical spinal stenosis most often develops due to degenerative changes in the spine, such as osteoarthritis or degeneration. A large, acute disc herniation or an unstable fracture compressing the spinal cord may also cause myelopathy.

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

• Normal wear and tear of everyday life
• Injury to your neck (spinal trauma)
• Diseases, such as arthritis
• Tumor

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

Myelopathy 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 ask for additional tests, such as:

• Imaging tests, including an MRI scan, an X-ray, or a CT myelogram of your neck
• Electrical tests to measure how well the nerves in your arms and hands 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 non-surgical 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 non-surgical treatment does not alleviate cervical myelopathy symptoms, surgery may be recommended. 

Since myelopathy is considered a progressive disease resulting in irreversible damage to 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. 

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 over 20 years of experience specializing in the treatment of spinal disorders in both adult and pediatric patients. He is highly skilled in advanced surgical and non-surgical techniques tailored to each patient’s individual condition.

For a personal consultation with Dr. Ball, please call us at (925) 838-8830 or request an appointment online.