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Cervical Myelopathy

This is a condition in which the lower or upper appendages of the body lose its functionality. It occurs as a result of damage to the cervical spine, which comprises of the first 7 vertebra from the skull. Such damage is directly caused by pressure exerted on the spinal cord located inside the neck. Apart from the extremities, this condition may affect bowel movement and cause bladder malfunction.

It does not only arise from physical aspect where spinal cord is compressed but can be contributed by any other non-physical mechanism that interferes with normal signal transmission by the neurons. Remember, spinal cord contains millions of neurons that transmit signals from the brains to the rest of the body.

Main causes of cervical myelopathy

• Fracture or dislocation of the cervical spine
• Trauma to the spine
• Inflammatory disorders which could be autoimmune such as neuromyelitis optica
• Tumor within the spinal cord
• Degenerative changes such as spondolysis where vertebral disks are worn out

Other than these direct causes, there exist some factors that may predispose one to it. These risk factors include:

• Viral infections
• Vascular disorders such as Ischemia where blood vessels supplying spinal cord are restricted
• Family history of spinal disorders or back pains
• Family history of cancer of the bones
• Inflammatory disorders due to autoimmune diseases such as arthritis
• Strenuous exercises or slouched posture

Symptoms of cervical myelopathy

Symptoms manifested may depend on the degree of damage and the position of vertebrae involved. They may vary from one patient to another; differ in the timing and pattern of progression.

These symptoms are:

• Numbness of the hands and feet
• Clumsy movement
• Stiffness of the legs
• Loss of balance or instability when walking
• Pain in the neck, shoulders and arms
• Irregular urination
• General muscle weakness
• Irregular bowel movement
• Loss of motor skills and memory
• Difficulty in breathing

Diagnosis of Cervical Myelopathy

Some of these symptoms are not uniquely linked to this condition and as such cannot offer absolute diagnosis. It is worth noting that obtaining correct diagnosis is the surest way to getting the right treatment.

Preliminary examination is based on obtaining information on preexisting family history, physical examination on muscles state and limb movement. Sometimes examinations involve neurological aspect to determine mental state, visual health and reflex response.

Further diagnosis requires obtaining of radiographic images of the neck. These images are produced using different gadgets to determine degree of damage to the cervical spine. These gadgets include:

• X-ray - projects general image of the cervical spine vertebra
• MRI (Magnetic Resonance Imaging) - project highly detailed images of the spine
• Myelographic CT - this scan projects compression on the spinal vertebrae

The present symptoms backed by any significant changes or signs of pressure to the vertebral column observed on these images are enough to ascertain it.

Treatment of cervical myelopathy

Treatment options depend on the severity of the symptoms and the degree of damage observed. Basically initial treatment incorporates alleviating the symptoms and prevention of further damage. These involve:

• Physiotherapy to regain lost limb functionality
• Remedy to alleviate pain
• Walking and sitting in the right posture
• Treating infections that could cause using prescribed corticosteroids and NSAIDs
• Regular exercises with fitness experts

The final treatment option is surgery. This being the last resort requires proper consultation with a neurosurgeon. Surgery is performed to release pressure exerted on the spine. There are a number of surgery options available. Some of the most common ones are:

• Cervical laminectomy - vertebral arch or lamina is surgically removed
• Cervical diskectomy - a vertebral disk is surgically removed then fused back
• Cervical corpectomy - both vertebra and the disks are removed before it is fused