Cervical Myelopathy
Cervical myelopathy occurs when the spinal cord in the neck becomes compressed, leading to neurological symptoms that can significantly impact daily function and quality of life.
Common Symptoms
Upper Extremity Symptoms
- Hand clumsiness and difficulty with fine motor tasks
- Difficulty buttoning clothes, writing, or using utensils
- Numbness and tingling in hands and fingers
- Weakness in arms and hands
Lower Extremity & Balance
- Unsteady gait and balance problems
- Leg weakness and stiffness
- Frequent falls or near-falls
- Bladder or bowel dysfunction (severe cases)
Progressive Nature
Cervical myelopathy typically progresses gradually over time. Early recognition and treatment are crucial to prevent permanent neurological damage. If you experience these symptoms, seek evaluation promptly.
Common Causes
Cervical Stenosis
Age-related narrowing of the spinal canal due to arthritis, ligament thickening, and bone spur formation.
Disc Herniation
Large central disc herniations that compress the spinal cord rather than individual nerve roots.
Congenital Stenosis
Naturally narrow spinal canal that becomes symptomatic with age-related changes.
Diagnosis
Clinical Examination
Dr. Greenberg performs specialized neurological tests including Hoffmann's sign, hyperreflexia assessment, and coordination testing to identify spinal cord compression.
Advanced Imaging
MRI is essential for visualizing spinal cord compression and signal changes. CT myelography may be used in complex cases to better define bony anatomy.
Functional Assessment
Detailed evaluation of hand function, gait analysis, and balance testing to assess the functional impact of myelopathy.
Fellowship-Trained Expertise
Dr. Marc Greenberg completed advanced fellowship training at Mayo Clinic, Johns Hopkins, and Brown University, bringing specialized expertise in complex cervical spine conditions and myelopathy management.
Specialized Training
- • Advanced cervical spine surgery techniques
- • Neurological assessment protocols
- • Motion-preserving surgical options
- • Minimally invasive approaches
Conservative Treatment
Limited Role of Conservative Treatment
Unlike other spine conditions, cervical myelopathy typically requires surgical intervention to prevent progression of neurological damage. Conservative treatment may provide temporary symptom relief but does not address the underlying spinal cord compression.
Medications
Anti-inflammatory medications and neuropathic pain medications for symptom management.
Physical Therapy
Gentle exercises to maintain mobility and strength while avoiding activities that worsen symptoms.
Activity Modification
Avoiding activities that involve neck extension or may increase spinal cord compression.
Monitoring
Close observation for progression of symptoms with prompt surgical intervention when indicated.
When to Consider Surgery
Surgical Indications
- Moderate to severe myelopathy symptoms
- Progressive neurological deterioration
- Significant functional impairment
- MRI evidence of spinal cord compression with signal changes
Timing is Critical
Early surgical intervention often leads to better outcomes. Delaying surgery may result in permanent neurological deficits.
Why Greenberg Spine
Our approach to cervical myelopathy emphasizes precise surgical planning and advanced techniques to achieve optimal decompression while preserving stability.
- • Robotic-assisted precision surgery
- • Advanced navigation technology
- • Motion-preserving techniques when appropriate
- • Comprehensive neurological monitoring
- • Minimally invasive approaches
Related Procedures
ACDF Surgery
Anterior cervical discectomy and fusion for single or multi-level decompression.
Cervical Disc Replacement
Motion-preserving option for select cases of single-level compression.
Cervical Laminoplasty
Posterior approach to expand the spinal canal while preserving motion.
Recovery Expectations
Surgical Recovery Timeline
Recovery from cervical myelopathy surgery varies depending on the procedure and severity of pre-operative symptoms. Most patients experience stabilization of symptoms immediately after surgery, with gradual improvement over months.
Realistic Expectations
The primary goal of surgery is to halt progression of myelopathy. Improvement in existing symptoms is possible but depends on the duration and severity of compression before surgery. Early intervention typically leads to better outcomes.
Recovery Milestones
Frequently Asked Questions
What is cervical myelopathy?
Cervical myelopathy is compression of the spinal cord in the neck region, causing neurological symptoms including weakness, coordination problems, and difficulty with fine motor tasks. It's a serious condition that typically requires surgical treatment.
What are the early signs of cervical myelopathy?
Early signs include hand clumsiness, difficulty with buttons or writing, balance problems, and subtle weakness. These symptoms often progress gradually over time, making early recognition important for optimal treatment outcomes.
Is surgery always necessary for cervical myelopathy?
Surgery is typically recommended for moderate to severe myelopathy to prevent progression of neurological damage. Unlike other spine conditions, conservative treatment rarely provides lasting relief for myelopathy. Early intervention often leads to better outcomes.
What surgical options are available?
Surgical options include anterior cervical discectomy and fusion (ACDF), cervical laminectomy, and laminoplasty, depending on the location and extent of compression. The choice depends on your specific anatomy and the pattern of spinal cord compression.
Can symptoms improve after surgery?
Surgery can halt progression and often leads to improvement in symptoms, especially when performed early. Recovery of function depends on the severity and duration of compression before surgery. The primary goal is preventing further neurological deterioration.
Experiencing Cervical Myelopathy? Schedule a consultation with Dr. Marc Greenberg.
Medical Disclaimer: This information is for educational purposes only and is not intended as medical advice. Individual outcomes may vary. Please consult with Dr. Greenberg or your healthcare provider for personalized medical advice regarding your specific condition.