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Cervical Myelopathy

(Myelopathy, Cervical)

Definition

Cervical myelopathy is damage to the part of the spinal cord that is in the neck. The cervical spine begins at the base of the skull. It extends to the first seven vertebrae.
Cervical Spine
Cervical Spine
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Causes

Cervical myelopathy is caused by:

Risk Factors

Factors that may increase your risk of cervical myelopathy include:

Symptoms

Symptoms may include:

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. It will focus on any muscle weakness. A neurological exam may also be done to check your:
Images may be taken of your bodily structures. This can be done with:
Other tests may include:

Treatment

Talk with your doctor about the best treatment plan for you. This may involve:

Surgery

If there is structural pressure on the spinal cord, you may need surgery right away. This is to attempt to avoid lasting injury. There are many different kinds of surgery and procedures to stabilize the neck, such as:
  • Diskectomy —a surgical procedure to remove part of an intervertebral disc that is putting pressure on the spinal cord or nerve root
  • Laminectomy —a surgical procedure to remove a portion of a vertebra, called the lamina
  • Fusion of the vertebrae
Cervical Fusion
Sagittal View of a Cervical Fusion
Screws and a plate prevent the vertebrae from putting pressure on the spinal cord.
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Nonsurgical Approaches

Nonsurgical approaches may include:
  • Physical therapy
  • Occupational therapy
  • Other approaches, such as ultrasound therapy, heat therapy, or electrical stimulation
  • Plasmapheresis

Medication

Medications may help to relieve symptoms. Common medications include:
  • Non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen
  • Corticosteroids
  • Rituximab—This is an antibody used to treat some autoimmune disorders.
Other medications that affect the immune system are also sometimes used.

Prevention

It is difficult to prevent this condition. Follow these guidelines to prevent accidents and strains:

RESOURCES

National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov

Spinal Cord Resource Center—United Spinal Association http://www.spinalcord.org

CANADIAN RESOURCES

Canadian Spinal Research Organization http://www.csro.com

Health Canada http://www.hc-sc.gc.ca

References

Cervical myelopathy. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/neurology%5Fneurosurgery/specialty%5Fareas/spine/conditions/cervical%5Fmyelopathy.html. Accessed November 20, 2014.

Check for safety: a home fall prevention checklist for older adults. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncipc/pub-res/toolkit/Falls%5FToolKit/DesktopPDF/English/booklet%5FEng%5Fdesktop.pdf. Published 2005. Accessed November 20, 2014.

Matsushima T, Yaoita H, et al. Operated family cases of cervical canal stenosis. International Congress Series. 2004;1259:465-469.

Pollard H, Hansen L, et al. Cervical stenosis in a professional rugby league football player: a case report. Chiropractic & Osteopathy. 2005;13:15.

Spondylolysis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 7, 2014. Accessed November 20, 2014.

Young WB. Clinical diagnosis of myelopathy. Sem Ultrasound, CT, MRI. 1994;15:250-254.

Young WF. Cervical spondylotic myelopathy: a common cause of spinal cord dysfunction in older persons. Am Fam Physician. 2000 Sep 1;62(5):1064-1070. Available at: http://www.aafp.org/afp/20000901/1064.html. Accessed November 20, 2014.

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