The cervical spine (neck) is made up of a series of bones called vertebrae.
The bones protect the spinal canal that runs through the vertebra and carries the spinal cord. The spinal cord contains nerves that give strength and sensation to the arms and legs, and provide bowel and bladder control. Numerous connections (discs, joints, ligaments and muscles) between the cervical vertebrae provide support, provide stability and allow motion.
Cervical Myelopathy is a condition where the spinal cord in the neck gets compressed. This is usually caused by degenerative changes in the disc and the facet joints, but can also be caused rarely by tumours.
About half of patients with cervical myleopathy have pain in their neck or arms, most have symptoms of arm and leg dysfunction.
Arm symptoms may include weakness, stiffness or clumsiness in the hands, such as being unable to button a shirt, turn a doorknob or open a jar.
Leg symptoms may include weakness, difficulty walking, loss of balance, frequent falls or the need to use a cane or walker as the disease progresses. Early symptoms are pins and needles in both hands.
Urinary urgency is also common. In late cases bladder and bowel incontinence can occur.
Symptom progression may also vary. You may experience a slow, steady decline or progress to a certain point and become stable, or your sypmtons may progress rapidly. The first signs are often brisk knee and ankle reflexes. These may only be detected in a neurological exam. Early detection is important to determine treatment which might help slow symptom progression.
Treatment options vary. Where the cord compression is marked or the symptoms severe or progressive, surgery is usually advised.
This can take the form of an anterior cervical decompression and fusion/disc replacement, or posterior laminectomy and stabilization.
Mild cases can be treated with physiotherapy, expectant watching, or local injections for pain relief.