Cervical Myelopathy

Cervical myelopathy occurs when the spinal cord in the neck becomes compressed, often due to age-related changes in the spine. This pressure interferes with how the brain communicates with the rest of the body, leading to neurological symptoms that can worsen over time.

The condition is most commonly associated with degenerative changes such as disc wear, bone spurs or narrowing of the spinal canal. Because the spinal cord controls many essential functions, early diagnosis and treatment are important to prevent permanent damage.

Cervical myelopathy can develop from different underlying causes, including:

• Degenerative cervical myelopathy (most common, related to aging)
• Congenital cervical stenosis (narrow spinal canal from birth)
• Traumatic cervical myelopathy (due to injury)
• Myelopathy caused by herniated discs or tumors

Symptoms of cervical myelopathy often develop gradually and may worsen over time. Common signs include:

• Neck pain or stiffness
• Weakness in the arms or hands
• Difficulty with fine motor skills, such as buttoning a shirt
• Numbness or tingling in the arms, hands or legs
• Balance problems or difficulty walking
• Muscle stiffness or spasticity
• Changes in bowel or bladder function in advanced cases

Because symptoms can overlap with other spine conditions, a thorough evaluation is important.

Cervical myelopathy is most often caused by changes that narrow the spinal canal and compress the spinal cord. Common causes include:

• Degenerative disc disease
• Bone spurs (osteophytes)
• Thickened ligaments in the spine
• Herniated discs
• Spinal stenosis in the cervical spine
• Trauma or injury to the neck

Risk factors include:

• Aging (most common in people over 50)
• Repetitive neck strain
• Previous neck injuries
• Congenital spinal abnormalities

Diagnosing cervical myelopathy typically involves a combination of clinical evaluation and imaging tests. Your provider may:

• Review your medical history and symptoms
• Perform a neurological exam to assess strength, reflexes and coordination
• Order imaging tests such as MRI or CT scans to evaluate spinal cord compression
• Use X-rays to assess spinal alignment and structural changes

Early and accurate diagnosis is critical to prevent progression of neurological symptoms.

Treatment for cervical myelopathy depends on the severity of symptoms and the underlying cause. Options may include:

Nonsurgical treatments (for mild cases):

• Physical therapy to improve strength and mobility
• Medications to reduce pain and inflammation
• Activity modification

Surgical treatments (often recommended for moderate to severe cases):

• Decompression surgery to relieve pressure on the spinal cord
• Spinal fusion to stabilize the spine
• Minimally invasive spine procedures when appropriate

Surgery is often the most effective way to stop progression and improve function, especially when neurological symptoms are present.

If left untreated, cervical myelopathy can lead to serious complications, including:

• Permanent nerve damage
• Loss of coordination and mobility
• Chronic pain
• Paralysis in severe cases
• Loss of bladder or bowel control

Prompt treatment can help reduce the risk of these long-term effects.

While not all cases can be prevented, certain steps may help reduce your risk:

• Maintain good posture and spinal alignment
• Stay physically active to support spine health
• Avoid repetitive strain on the neck
• Seek early care for persistent neck pain or neurological symptoms

Regular medical care can also help identify spine problems before they progress.

If you are experiencing symptoms such as weakness, numbness or balance issues, it’s important to seek medical evaluation. Early diagnosis and treatment can help prevent progression and improve outcomes.

To schedule a visit with a Baptist Health Brain & Spine Care provider, fill out an appointment request form or call 833-596-3876.