Cervical myelopathy is a neurological condition caused by compression of the spinal cord in the neck region. This compression disrupts the normal transmission of signals between the brain and the body, which can impact strength, mobility, and even basic daily functions. If not detected early, this condition can progress and lead to significant neurological damage.
In many patients, this compression develops gradually due to age-related degenerative changes or structural issues such as herniated discs or traumatic injuries. In its early stages, symptoms may go unnoticed or be mistaken for common muscular discomfort.
Common Causes of Cervical Myelopathy
The spinal cord plays a vital role in transmitting commands from the brain to the rest of the body. When there is compression in the cervical region, this connection is disrupted, affecting both upper and lower limbs. The main causes of this compression include:
- Age-related degeneration: Over time, intervertebral disc lose height and elasticity, reducing the space available for the spinal cord.
- Cervical disc herniation: A portion of the disc protrudes into the spinal canal, exerting direct pressure on the spinal cord.
- Traumatic injuries: Fractures or impacts to the cervical spine can lead to displacements that compromise the spinal cord.
- Osteophyte formation: Bone spurs from arthritis can narrow the spinal canal.
This type of compression may not cause discomfort at first, but over time it leads to symptoms that affect quality of life and the ability to perform daily work tasks. A personalized medical evaluation is ideal to determine whether your activities pose a risk to your neurological health.
How Is This Condition Diagnosed?
Early diagnosis of cervical myelopathy is crucial to avoid permanent damage. The process begins with a detailed clinical evaluation by a neurosurgeon, who assesses muscle strength, coordination, sensitivity, and reflexes.
Some warning signs that may indicate this condition include:
- Loss of strength in the arms or hands
- Clumsiness or instability while walking
- Tingling or numbness in the limbs
- Difficulty performing fine motor tasks, such as buttoning a shirt
To confirm the diagnosis, the following tests may be ordered:
- Magnetic Resonance Imaging (MRI): Shows the degree and location of the spinal cord compression.
- X-rays and CT scans: Help evaluate vertebral alignment and detect signs of arthritis.
- Electromyography (EMG): Assesses the functional status of the affected nerves and muscles.
Available Treatment Options
Treatment will depend on the patient’s clinical condition and the degree of compression observed. There are two main approaches:
Conservative Treatment
Recommended for mild cases or when there are no progressive neurological symptoms. This may include:
- Specific physical therapy to stabilize and relieve the cervical region
- Anti-inflammatory and pain-relief medications
- Modifications to daily activities to avoid cervical overload
Regular follow-ups are essential, as the compression may progress even without significant pain.
Surgical Treatment
Surgery is recommended when there are signs of neurological decline or when conservative treatment is not effective. The most common surgical techniques include:
- Anterior cervical decompression and fusion: The disc or bone causing the pressure is removed, and the spine is stabilized with a plate.
- Posterior cervical laminectomy: Access to the spinal cord is gained from the back of the spine to widen the spinal canal.
When to Seek Medical Advice
If you experience weakness, sensory changes, or difficulty walking, it is advisable to see a specialist as soon as possible. In cases of cervical myelopathy, time is a key factor. The earlier the intervention, the greater the chances of preserving functionality and avoiding complications.
If you have noticed any of the symptoms described above, do not hesitate to seek a specialized evaluation. I am Dr. Andrés Morales, neurosurgeon, and I would be glad to offer you a precise diagnosis and a comprehensive treatment plan tailored to your condition. Timely care not only prevents complications but can also significantly improve your quality of life.
