Cervical & Thoracic Myelopathy

Cervical Myelopathy (Arthritic)
Myelopathy Comparison

Overview

Cervical myelopathy occurs when there is pressure on the spinal cord in the neck or thoracic spine, resulting in clumsiness in the hands and difficulty with balance and gait. The most common cause is arthritis in the neck or back, but it can also be caused when people are born with a narrow spinal canal. There are other less common causes, all of which result in compression of the spinal cord. Myelopathy typically results in a stepwise deterioration over time but rarely improves without surgery.

Symptoms

Myelopathy can affect both the upper and lower extremities because of the pressure on the spinal cord. Symptoms can vary, but most people have clumsiness in the hands and may find that they often drop objects or have trouble with fine motor movements such as buttoning buttons. People may also have trouble with walking and balance. Neck pain and numbness, tingling, or aching in the arms or legs is also common. Later in the development of symptoms, patients can have trouble with bowel and bladder function and can even be confined to a wheelchair.

Imaging

X-rays only show bones and can help identify arthritis in the neck or back. However, X-rays cannot demonstrate pressure on the spinal cord.  

With persistent symptoms that are unbearable or have lasted longer than a month, an MRI is often necessary. MRI scans, unlike X-rays, have the ability to illustrate pressure on the spinal cord. 

Prevention

Cervical myelopathy may be prevented by avoiding the following: improper lifting, excessive body weight, repetitive strenuous activity, and smoking. In other instances such as being born with a small spinal canal, there is no way to prevent myelopathy.

Treatments:

Cervical Disc Replacement (Minimally Invasive)

Thoracic Facet Injections

Cervical Disc Replacement

Thoracic Transforaminal Injections

Cervical Transforaminal Injections

Thoracic Interlaminar Epidural Steroid Injections

Cervical Interlaminar Epidural Steroid Injections

Posterior Cervical Fusion

Medications

Anterior Cervical Discectomy & Fusion (ACDF)

Physical Therapy