Cervical Myelopathy
The Truths Behind Cervical Myelopathy
By Neurosurgery Singapore
What is Cervical Myelopathy?
Cervical myelopathy is a condition caused by compression (pressure or squeezing) of the spinal cord in the neck. This compression prevents the spinal cord from working properly, leading to a range of symptoms. These may include balance problems that affect walking, reduced hand coordination, and issues with bowel or bladder control. Patients may also experience pain, numbness, tingling, or weakness in the arms or hands. Symptoms often develop gradually and may appear to level off, but cervical myelopathy is generally a progressive condition that can worsen over time if left untreated.
What are some symptoms of Cervical Myelopathy?
It’s common to experience one or more symptoms of cervical myelopathy, which may vary in severity.
The most frequently reported symptoms include:
Neck pain or stiffness
Tingling or numbness in the arms or legs — often starting in the fingertips or toes, and occasionally affecting other areas of the body
Loss of hand coordination or fine motor skills, such as difficulty fastening buttons or tying shoelaces
Pain, weakness, or a heavy sensation in the arms or legs
Imbalance or unsteadiness, which may increase the risk of falls
Difficulty walking
Changes in bladder or bowel function, including increased urgency or, in some cases, incontinence
“In addition to age-related wear and tear, cervical myelopathy can also be caused by the hardening of ligaments around the spinal cord—such as the posterior longitudinal ligament and ligamentum flavum. This hardening can lead to pressure on the spinal cord..”
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What types of treatments?
The cervical myelopathy treatment depends entirely on the cause of the problem. Therefore, it is of utmost importance that you understand the cause of your symptoms before embarking on a treatment program. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment.
There are some nonsurgical treatments that may help relieve symptoms of cervical myelopathy, such as physical therapy or wearing a cervical collar to reduce strain on the neck. However, these approaches do not address the underlying spinal cord compression. To relieve the pressure and prevent the condition from worsening, surgery is often necessary.
Several surgical options are available, and the best one depends on your specific condition:
Laminoplasty: This motion-preserving procedure involves widening the spinal canal and is suitable for certain patients with multi-level compression.
Decompression with spinal fusion: This involves removing herniated discs, bone spurs, or thickened ligaments to relieve pressure on the spinal cord. The spine is then stabilized using spinal fusion.
These procedures can be performed anteriorly (from the front of the neck) or posteriorly (from the back). Our neurosurgeon will recommend the most appropriate surgical approach based on the location and severity of your spinal cord compression, overall spine alignment, and your individual needs.
What is the outcome for Cervical Myelopathy surgery?
Regardless of the surgical approach, the primary goal is to stabilize the spine and prevent further worsening of neurological symptoms. A secondary benefit may include relief of neck pain and improvement in motor, sensory, or other neurological issues. However, it’s important to understand that surgery is not always intended to fully restore normal function.
Recovery outcomes can vary from patient to patient. Generally:
About one-third of patients improve
One-third remain the same
One-third may continue to decline over time
In many cases, the symptoms you have after surgery may be similar to what you experienced before. Our doctor will discuss your individual condition and provide guidance on the likelihood of improvement based on your specific situation.
Frequently Asked Questions about Cervical Myelopathy
1. What causes cervical myelopathy?
2. What are the early signs of cervical myelopathy?
3. Can cervical myelopathy be treated without surgery?
Why Early Diagnosis Matters
Early detection and treatment are key to preventing permanent damage. If you’re experiencing symptoms that affect your balance, hand coordination, or bladder control, consult our specialist for evaluation and guidance on next steps.
