Overview
Cervical myelopathy happens when the spinal cord in the neck is squeezed, most often by age-related changes such as disc bulges, bone spurs and thickened ligaments (degenerative cervical myelopathy). Because the spinal cord carries signals to the arms, legs, bladder and bowel, compression can affect function well beyond the neck.
Myelopathy often progresses slowly, and early signs are easy to miss. When symptoms are progressing, surgery to relieve pressure on the cord is often recommended to help prevent further loss of function.
Watch and learn
Video: “Cervical Myelopathy Explained: Causes, Symptoms & Treatments | DePuy Synthes” from DePuy Synthes on YouTube. It loads from youtube-nocookie.com only when you press play. Shown for general education; GSMC did not produce it. Watch on YouTube
Video: “What You Should Know: Cervical Myelopathy” from NASSspine on YouTube. It loads from youtube-nocookie.com only when you press play. Shown for general education; GSMC did not produce it. Watch on YouTube
Captions: press the CC button in the video player to turn on captions. Some captions are generated automatically by YouTube and may contain errors.
Symptoms
- Clumsy hands, trouble with buttons, writing or picking up small objects
- Numbness or tingling in the hands
- Balance problems or a wide, unsteady walk
- Weakness in the arms or legs
- Neck pain or stiffness (not always present)
- In advanced cases, bladder or bowel changes
Causes
- Age-related disc degeneration and bone spurs (cervical spondylosis)
- Disc herniation pressing on the cord
- Thickening or calcification of spinal ligaments
- A naturally narrow spinal canal
- Prior injury, instability or inflammatory arthritis
How it is diagnosed
Diagnosis combines a neurological exam (reflexes, strength, sensation, balance and hand function) with MRI of the cervical spine. CT, X-rays with bending views, or nerve testing (EMG) may be added to rule out other causes.
Treatment options, step by step
A spine surgeon looks at the whole picture, including options short of surgery. Not every step applies to every person.
Self-care and lifestyle
Self-care alone is not enough for progressive myelopathy. Avoid activities with a high fall risk and report any change in balance or hand function promptly.
Physical therapy and medications
Physical therapy and close monitoring may be reasonable for mild, stable symptoms after a surgeon has reviewed your case.
Injections and nerve blocks
Injections do not treat spinal cord compression, though they are sometimes used for coexisting arm pain from a pinched nerve.
Minimally invasive procedures
Minimally invasive options depend on the location and amount of compression.
Surgical evaluation
Surgical decompression, from the front (ACDF or disc replacement) or the back (laminectomy with fusion), is considered for moderate or progressing myelopathy.
Nonsurgical alternatives
Many spine problems are managed without surgery. See our nonsurgical options and holistic and lifestyle care guides.
Related surgeries
- ACDF (Anterior Cervical Discectomy and Fusion)
- Posterior Cervical Fusion
- Laminectomy / Decompression
- Cervical Disc Replacement
Call 732-202-3000 to confirm which surgeon performs this procedure and where.
When to seek urgent care
Call 911 or go to the emergency department for new or rapidly worsening weakness, numbness in the groin or inner thighs, loss of bladder or bowel control, or severe pain after a fall or accident.
Frequently asked questions
Is cervical myelopathy an emergency?
Rapid worsening of weakness, balance or bladder control needs urgent care. Most myelopathy develops slowly, but it should be evaluated promptly by a spine specialist.
Can myelopathy get better without surgery?
Mild cases are sometimes monitored, but myelopathy generally does not reverse on its own. The goal of surgery is usually to stop progression; some symptoms may improve.
What is the difference between myelopathy and radiculopathy?
Myelopathy is compression of the spinal cord itself. Radiculopathy is compression of a single nerve root, which usually causes pain or numbness down one arm.
This page is general patient education and does not replace advice from your own clinician. Individual results vary.