What Are the Treatments for Cervical Myelopathy?

Cervical myelopathy causes the canal housing the spinal cord to narrow. It stems from age-related breakdown of the joints in the neck. Cervical myelopathy causes pain, numbness and weakness and can interfere with your ability to move your arms, legs and neck. Depending on the severity, it can lead to permanent disability. Treatment will depend on the seriousness of your condition and includes both non-surgical and surgical options.

Medication

• You can treat mild pain with over-the-counter pain relievers like Advil and Motrin. If your pain is more intense, a doctor might prescribe muscle relaxants like Robaxin or Flexeril or other medications that act on pain, such as antidepressants or antiseizure medications. Narcotic opioids like Oxycontin can treat pain, but due to their addictive nature, they are usually reserved as a last resort. Steroid injections between the vertebrae reduce pain and inflammation, but can cause serious side effects when used long-term.

Rehabilitation

• Cervical myelopathy can interfere with physical activity, reduce flexibility and strength and reduce cardiovascular endurance. A rehabilitation program of at least three months with a physical therapist can improve your condition and help you with day-to-day living. You will receive instruction on various exercises to increase strength and flexibility. Your therapist will show you how to continue your treatment at home to preserve and build on the benefits of the program. After surgery, your doctor will suggest you participate in these programs, but you can also benefit even if you have not had surgery.

Surgery Overview

• When non-surgical options fail, your doctor will usually recommend surgery, especially if neurological symptoms, like weakness in the arms and legs, worsen. These surgeries carry certain risks including infection, a tear in the membrane covering the spine, bleeding, blood clots in the leg and a worsening of neurological symptoms. Furthermore, there are no guarantees the procedure will fix all of the issues associated with your condition. Several factors determine the type of surgery and include the location of the compression, the quality of your bones and the overall status of your condition. You typically remain in the hospital for several days and fully recover within six to nine months.

Anterior Surgery

• Anterior surgery involves an incision in the front of the neck. The surgeon removes the discs and bone spurs (abnormal bony growths), putting pressure on the spinal cord and nerves. He will insert an implant to replace the disc and fuse the vertebrae together.

Posterior Surgery

• Posterior surgery utilizes an incision at the back of the neck and aims to relieve pressure from the spinal cord and nerves. Two commonly performed procedures are a laminectomy and laminaplasty. A laminectomy involves removing the rear parts of the vertebra (lamina) A laminaplasty consists of removing the bony arch and creating a hinge that makes room for the spinal cord.