Myelopathy is an umbrella term used to mean any damage to the spinal cord. Your spinal cord is a tube-like bundle of nerves that runs from the base of your brain down the middle of your back, carrying messages between the brain and most parts of your body. Cervical myelopathy is damage to the spinal cord at the level of the neck - the first seven vertebrae (backbones) of the spine, and the eight nerve roots located there.
When the spinal cord is compressed or squeezed, this results in a disruption of the electrochemical signals between brain and body. The most common cause of cervical myelopathy is compression due to spondylosis, which is age-related wear and tear on the spinal column. It can also include degeneration of the spine due to osteoarthritis. Sometimes this can cause bone spurs, or pointy projections on the bones that can put pressure on the spinal cord.
According to the Mayo Clinic, more than 85% of people over age 60 are affected by cervical spondylosis. Sometimes you will hear cervical myelopathy referred to as cervical spondylitic myelopathy, or CSM, to indicate that spondylosis is the cause of the problem.
As the spine's shape changes due to spondylosis, it can cause an abnormal narrowing of the spinal cord that doctors call spinal stenosis. Stenosis can also be the result of genetics, in which case it is known as congenital stenosis. If you develop cervical myelopathy in your 30s or 40s, it's likely that you have a congenital stenosis.
Other risk factors for cervical myelopathy include a history of bone, back, or neck problems; autoimmune conditions such as rheumatoid arthritis or multiple sclerosis also increase your risk, as do cancer involving the bones, and practicing a job or sport that strains the spine.
If you are over 55 or 60, you are more likely to develop the condition. You are more likely to develop the condition if you are a man. If you are a woman, the age of onset will likely be delayed. But by age 70, most men and women will show some signs of cervical myelopathy.
The following are some of the symptoms of cervical myelopathy:
A diagnosis of cervical myelopathy is made by a clinical examination, and verified by imaging tests. Imaging can include x-rays, a CT scan, MRI, and myelography (a test in which dye is injected into the spinal canal before a CT scan or x-ray.) Imaging can detect any bone abnormalities such as bone spurs or spondylosis, and can also help to pinpoint where nerves are being pinched.
Your doctor may also recommend nerve function tests such as an electromyography, or EMG. Nerve function tests look at whether the signals are traveling properly along the spinal column from the brain to the extremities, and back again.
The International Statistical Classification of Diseases and Related Health Problems, ICD-10, uses the code M50.02 to indicate cervical myelopathy; this is the code that should accompany your diagnosis for insurance purposes. You may see it specified in your paperwork as, "Cervical disc disorder with myelopathy, mid-cervical region."
Because it is generally a progressive condition, the preferred treatment for cervical myelopathy is surgery. This is particularly so if the patient is experiencing a great deal of pain, or if the condition interferes with the activities of daily living. There are a number of different surgical approaches that can improve the condition. Your surgeon will recommend the operation that best addresses your particular needs.
Some patients are treated with a more conservative approach that involves pain medication, physiotherapy, and modification of activities. If your symptoms are not improved with this approach after a few months, you may be a candidate for surgical treatment of your cervical myelopathy.