Causes, Symptoms, and Treatment Options
Cervical myelopathy is a condition caused by compression of the spinal cord in the neck (cervical spine). This can affect balance, hand coordination, and walking, and may lead to permanent damage if untreated. Early diagnosis and appropriate management—whether surgical or non-surgical—are essential for the best outcomes.
What Is Cervical Myelopathy?
Cervical myelopathy is a progressive condition where the spinal cord is compressed at the neck (cervical) level. It is most commonly caused by age-related wear and tear (degenerative cervical spondylosis), but may also result from disc bulges, ligament thickening, bone overgrowth (osteophytes), or congenital narrowing of the spinal canal.
Common causes include:
- Degenerative changes in the spine
- Thickened ligaments or ossified structures (like the posterior longitudinal ligament)
- Trauma
- Tumours or abscesses
- Autoimmune or inflammatory conditions
- Congenital spinal narrowing
Who Is Affected?
Cervical myelopathy typically affects people aged 60 and above and is more common in men. Risk increases with spinal arthritis, past injuries, or congenital spinal canal narrowing.
Symptoms to Watch For
- Numbness or tingling in the hands or arms
- Weak grip and hand clumsiness
- Gait disturbance – unsteady walking or balance issues
- Neck stiffness or mild pain
- In severe cases, bladder or bowel changes
How Is It Diagnosed?
Diagnosis involves:
- Clinical assessment: Neurological examination for reflexes, balance, and motor function
- MRI scan: Best for visualising spinal cord compression and inflammation
- X-rays and CT scans: Show bone structure, alignment, and any bony narrowing
Severity is often classified using scoring systems like the Nurick or JOA scale.
Treatment Options
Non-Surgical (for mild, stable cases)
- Anti-inflammatory medication (NSAIDs)
- Nerve pain medication (e.g. gabapentin)
- Physiotherapy to improve posture and gait
- Neck collars (short-term use only)
- Note: This approach does not reverse spinal cord compression.
Surgical Treatment (recommended for moderate to severe cases)
- Anterior Cervical Discectomy and Fusion (ACDF): Removes the disc causing compression and fuses the spine
- Corpectomy: Removes part of the vertebra for more extensive decompression
- Posterior laminectomy with fusion: Relieves pressure across multiple levels
- Laminoplasty: Expands the spinal canal while preserving some motion
Your surgeon will select the best approach based on the number of levels involved, spinal alignment, and overall health.
What Are the Risks of Surgery?
As with any operation, risks may include:
- Infection or bleeding
- Nerve or spinal cord injury
- Swallowing difficulties or hoarseness (in anterior surgery)
- C5 nerve palsy (with posterior surgery)
- Need for additional surgery in the future
Recovery and Rehabilitation
- Most patients stay in hospital for 1–7 days
- Return to desk work may be possible within weeks
- Full recovery and return to activities typically occur within 3–4 months
- Physiotherapy focuses on strength, posture, balance, and safe movement
- Some patients wear a neck brace for a short period
Long-Term Outlook
Recovery depends on:
- How soon surgery is performed (earlier is better)
- Severity of symptoms and any changes on the MRI scan
- Overall health and number of spinal levels involved
Without treatment, cervical myelopathy usually worsens over time.
Can It Be Prevented?
While cervical myelopathy cannot always be avoided, steps that support spinal health include:
- Good posture and ergonomic adjustments
- Regular neck-strengthening exercises
- Maintaining a healthy weight
- Avoiding high-impact neck movements
- Managing chronic conditions like diabetes
Patient Support and Advice
Call to Action
If you have pain, book an appointment to be reviewed by Prof Imam or another member of our specialist team at The Arm Clinic. Early specialist care helps prevent long-term issues. Visit www.TheArmDoc.co.uk or book your consultation today. Phone: 020 3384 5588 | Email: Info@TheArmDoc.co.uk
Disclaimer
This information is for general educational purposes and should not be used as a substitute for professional medical advice. Consult a healthcare professional for individual guidance on your condition and treatment options.
This page was last clinically updated in May 2025