Spinal Cord Compression / Cervical Myelopathy

Ageing, injury, trauma and disease can cause degeneration or a narrowing of the spinal canal that protects the spinal cord and nerves. Abnormal pressure caused by bone spurs, herniated discs, arthritis or injury can damage or pinch the spinal cord and nerve roots. This condition is known as cervical myelopathy.

Symptoms

Symptoms of cervical myelopathy can include:

• loss of balance and lack of coordination
• deterioration of fine motor skills
• heavy feeling and shooting pain in legs and arms
• painful or stiff neck.

Diagnosis and Treatment Options

To diagnose cervical myelopathy, diagnostic tests are necessary. These may include x-rays, computed tomography (CT) or magnetic resonance imaging (MRI) scans. A physical and neurological examination is carried out and medical history including symptoms is recorded, muscle strength and reflexes are tested.

A myelogram, which is a special type of CT scan might be recommended. It uses dye injected into the spine to clearly show the spinal cord and nerve roots. Somatosensory evoked potentials (SSEP) can also be useful. It uses electrical pulses to stimulate the arms and legs and reveal any spinal cord compression.

Non-surgical treatments such as soft cervical collars, physical therapy, upper body exercises, medications and anti-inflammatories may help to relieve the pain of myelopathy. If these do not relieve the symptoms, we will recommend surgery for decompression of the spinal canal.

Surgical procedures may include:

• Anterior cervical discectomy and fusion (ACDF)
• Disc arthroplasty / artificial cervical disc
• Cervical laminectomy / discectomy
• Corpectomy

Recovery

Your neck will most likely feel stiff or sore and you may find it hard to sit still for long periods. It might be difficult to lift and bend without straining your neck and back and causing pain. Pain medication will usually be prescribed.

Recovery differs between patients and surgeries. As a general guide the following are consistent with all cervical surgeries:

• Three to five days in hospital
• No heavy lifting for the first few weeks or so (and graduated lifting restrictions thereafter)
• Some time off work in order to recover
• You may need to return to work on restricted duties for a period of time
• You may not be able to drive for 4 to 6 weeks
• No swimming for 4 to 6 weeks
• Physiotherapy
• Pain medication
• Rehabilitation depending on the surgery