Cervical Spondylotic Myelopathy: Causes, Symptoms and Treatments

Cervical spondylotic myelopathy (CSM) is a common cause of spinal cord dysfunction in older adults. It occurs when wear and tear on the spine causes bone spurs or disc herniations to press on the spinal cord in the neck.

This compression disrupts nerve signaling and leads to pain, muscle weakness, and disability. Read on to learn what causes cervical spondylotic myelopathy, how it is diagnosed, and what treatments are available.

What Causes Cervical Spondylotic Myelopathy?

As we age, degenerative changes often occur in the cervical (neck) spine that can contribute to cervical spondylotic myelopathy. These include:

• Bone spurs (osteophytes): Extra bone forms along the edges of the vertebrae and can pinch or compress the spinal cord.

• Herniated discs: The jelly-like discs between vertebrae lose hydration and collapse, allowing the vertebral bones to rub together or place direct pressure on the spinal cord.

• Ligament thickening: Connective tissues thicken and can press on or constrict the spinal cord.

These degenerative changes usually develop slowly over decades. Patients may not experience significant cervical spondylotic myelopathy symptoms until the spinal cord becomes substantially compressed in later life.

Symptoms of Cervical Spondylotic Myelopathy

Common symptoms of CSM include:

• Neck pain or stiffness

• Numbness, tingling, or unusual sensations in the shoulders, arms, or legs

• Poor coordination when walking or using hands

• Weak grip

• Loss of manual dexterity

• Difficulty with urination or bowel movements

• Frequent tripping or falling

The hallmark of cervical spondylotic myelopathy is that symptoms tend to progressively worsen over time as more spinal cord damage occurs. Early diagnosis and treatment are key to halting disease progression.

Diagnosing Cervical Spondylotic Myelopathy

To diagnose CSM, physicians conduct:

• Medical history review: Looking for common symptoms.

• Physical examination assessing balance, gait, dexterity, and changes in reflexes.

• Cervical spine imaging: X-rays, CT, or MRI to visualize bone spurs or herniated discs pressing on the spinal cord.

• Electromyography: Assesses nerve conduction between the brain, spinal cord, and extremities.

These diagnostic tools allow physicians to confirm cervical spondylotic myelopathy and evaluate the location and severity of spinal cord compression to guide treatment.

Treatments for Cervical Spondylotic Myelopathy

The goals of CSM treatment are to alleviate pain, resolve neurological symptoms, stabilize the spine, and prevent further spinal cord damage. Both non-surgical and surgical interventions may be utilized.

Nonsurgical Treatments:

• Neck immobilization brace.

• Medications like anti-inflammatories, and muscle relaxants.

• Cervical traction to take pressure off compressed spinal nerves.

• Physical therapy and occupational therapy.

When non-surgical treatments fail to improve disabling myelopathy symptoms, spine specialists may recommend surgery.

Surgical options include:

• Cervical decompression - Removing bone spurs and thickened ligaments to relieve cord compression

• Cervical fusion - Fusing vertebrae for stabilization

• Disc replacement - Removing degenerated disc and implanting an artificial disc

Recovering from cervical spine surgery requires extensive physical therapy over 3-6 months to rebuild strength and range of motion. With appropriate treatment, many CSM patients see significant improvement.

How Dr. Nitin Khanna Can Help with Cervical Spondylotic Myelopathy?

Dr. Nitin Khanna is a fellowship-trained orthopedic spine surgeon specializing in complex spine procedures like those used to treat cervical spondylotic myelopathy. With 20+ years of experience, Dr. Khanna provides personalized surgical and nonsurgical treatment plans utilizing leading-edge techniques.

If you are experiencing symptoms like hand clumsiness, balance issues, neck pain, or numbness in the arms and legs, you may benefit from Dr. Khanna’s expertise. He determines the precise location of cord compression causing neurological deficits and skillfully performs cervical decompression and fusion surgeries to halt myelopathy progression.