What Are the Treatments for Cervical Spondylotic Myelopathy?

As we age, the spine compresses and the discs between the vertebrae breakdown. When this happens it can decrease the function of the spine causing a disorder called Cervical Spondylotic Myelopathy (CSM). CSM can occur at any age, but it is most commonly found in a person over 50. The narrowing of the cervical spinal canal results in many symptoms that make daily tasks difficult to manage.

• Elderly Couple

Symptoms

• There are several main symptoms of CSM. Numbness or weakness in the arms is a common symptom. Your neck may also be stiff or experience pain. Due to compressed nerves, there may also be radicular pain in the arms. You may also experience numbness or weakness in the legs causing balance and coordination problems. Not everyone will experience the same symptoms at the same intensity.

Alternate Theories

• When you first visit your doctor regarding your symptoms, she will rule out other possible causes for your symptoms. Since there are other diseases and disorders having similar symptoms as CSM, she will want to ensure her diagnosis is correct. The symptoms of CSM are similar to Lou Gehrig's disease, some spinal cord tumors, and some forms of multiple sclerosis, among others.

Diagnosing

• Once your doctor has ruled out other possible causes, there are several paths he may take to determine if you have CSM. First, he will study your medical history and review your symptoms. You will likely then be sent for one or more tests to verify the disorder. When bone details must be seen, he will order a cervical myelogram, followed by a post-myelogram CT. Another common test is an MRI. These tests, along with other diagnostic testing, will help determine the severity of your disorder.

Non-Surgical Treatments

• Once CSM has been diagnosed, treatment options will be explored. The first step will be nonsurgical options. Your doctor will prescribe steroid and nonsteroid anti-inflammatory medications. She will also recommend periodic stabilization and immobilization of the neck. You will also visit a physical therapist. You may also be put in cervical traction or receive epidural steroid shots, depending on the progression of the disorder.

Surgical Treatments

• If improvement is not seen with conservative treatment methods, your doctor will consider the benefits of surgery. Depending on the exact nature of your CSM, there are several surgical options. Your doctor will recommend a laminectomy or an anterior cervical decompression. Both options are aimed at relieving the pressure on the spinal cord. Your doctor may also use plates or screws.