Myelopathy is a term used to refer diseases that affect the spinal canal. One of the most common neck conditions that occurs with age is cervical spondylotic myelopathy (CSM). Over time the normal wear and tear effects of aging can lead to a narrowing of the spinal canal.
Spinal cord compression is a very common neck condition affecting older people in the United States. Repeated trauma from activities such as carrying heavy loads or sports increases the risk of CSM. The gradual wear and tear because of aging causes narrowing of the spinal canal that leads to compression of the spinal canal.
Symptoms usually begin after the age of 50, but can occur earlier if there was an injury to the spine at a younger age. Many people with CSM will have steady progression of their disease. Once symptoms start, they tend to continue. Some of the common symptoms experienced are:
- Pain and stiffness of the neck
- Loss of balance and coordination
- Tingling sensation and numbness
- Weakness; troubling lifting objects, dropping things
Your doctor may ask about your symptoms and examine your neck to look for any abnormal reflexes, numbness and atrophy of muscles. Some of the diagnostic tests such as X-rays, magnetic resonance imaging, and myelogram may be done to confirm the diagnosis. Myelogram is a special type of computed tomography (CT) scan in which a dye is injected prior to the scan in order to get a clearer outline of the spinal cord.
Nonsurgical methods provide temporary relief from the symptoms in some case. However, in many cases surgery is advised as non-operative treatment will not reverse the compression most of the time.
If non-operative measures are tried, these options include:
- Soft Collars: Soft collars can be worn to allow the neck muscles to rest and restrict neck movements. This also helps in decreasing the pinching of nerve roots during movement. These collars should only be worn for short periods of time, as they will decrease the strength of neck muscles.
- Exercise: Simple exercises help to improve the strength and flexibility of your neck may lessen discomfort.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications such as aspirin and ibuprofen can be taken to reduce swelling and painful symptoms.
- Epidural steroid injections: Cortisone injections are given directly into the epidural space to decrease swelling as well as pain.
Surgery of the spine is considered in case your symptoms do not alleviate with the conservative treatment methods. The main goal of surgery is to relieve cord compression. Sometimes a fusion will also be needed depending on your condition. Whether to have surgery or not is a complex decision that that needs to be made between you and your doctor. The four common operations for CSM include:
- Cervical Laminoplasty
- Cervical Laminectomy and Fusion