A clinical condition affecting a specific part of the spinal cord, cervical myelopathy occurs when the space in which the spinal cord rests is compressed (spinal stenosis), resulting in damage to underlying nerves. This damage results in loss of normal function in all the nerves in the cervical portion of the spine.
There can be different conditions that cause the compression leading to cervical myelopathy, including a disc herniation or rupture, osteoarthritis that has lead to bone spurs and spinal column stress as a result of an existing tumor. Infections and inflammations, as well as injuries, can also cause the condition, but such cases are relatively rare.
Depending on where the compression, or squeezing, is centered, the symptoms of cervical myelopathy can vary. Weakness in the muscles of upper and lower limbs may indicate compression near the cervical vertebra and may be accompanied by bowel and bladder disorders as well as a change in skin sensation. On the other hand, compression of the spine column at a lower level (in the thoracic and lumbar regions for example) may result in a limiting of movement in the legs, difficulty walking, changes in skin sensation and, in severe cases, paralysis.
An accumulation of blood around the spinal cord or the presence of an abnormal blood vessel (arteriovenous malformation) as the cause of compression typically presents with slow onset and progression of symptoms. However, patients experiencing pain in a very specific nerve or set of nerves—known as radiculopathy) may have an infection or tumor that is causing the compression of the spinal cord.
Cervical myelopathy should be viewed as an acute condition and diagnosed and treated quickly after the onset of symptoms. A simple physical exam coupled with CT or MRI imaging is sufficient to diagnose most cased of cervical myelopathy and determine where it originated.
Once diagnosed, it’s vital that the pressure being exerted on the spinal cord be relieved immediately, and treatment to do so most often comes in the form of surgery combined with pain-relieving medications.