Spinal Cord Compression / Cervical Myelopathy

Ageing, injury, trauma, and disease can cause degeneration or narrowing of the spinal canal, which protects the spinal cord and nerve roots. Pressure caused by bone spurs, herniated discs, arthritis, or injury can compress and damage the spinal cord and nerves. This condition is known as cervical myelopathy.

Symptoms

Symptoms of cervical myelopathy may include:

• Loss of balance and co-ordination
• Deterioration of fine motor skills
• Weakness, heaviness, or shooting pain in the arms and legs
• Neck pain or stiffness
• Numbness or tingling in the hands, arms, or legs
• Difficulty with walking or maintaining balance

Diagnosis and Treatment Options

To diagnose cervical myelopathy, a thorough medical history, physical examination, and neurological assessment are performed. Your symptoms, muscle strength, reflexes, sensation, and co-ordination will be evaluated.

Diagnostic investigations may include X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI) scans. A myelogram, a specialised imaging study that uses contrast dye injected into the spinal canal, may also be recommended to provide detailed images of the spinal cord and nerve roots.

Somatosensory evoked potentials (SSEPs) may be used to assess nerve function. This test uses small electrical impulses to stimulate the arms and legs and helps identify abnormalities caused by spinal cord compression.

Non-surgical treatment options may include the use of a soft cervical collar, physiotherapy, exercise programs, anti-inflammatory medications, and pain-relieving medications. These treatments may help manage symptoms and improve function. However, if symptoms persist or neurological impairment progresses, surgery may be recommended to decompress the spinal cord and relieve pressure on the nerves.

Surgical procedures may include:

• Anterior cervical discectomy and fusion (ACDF)
• Cervical disc arthroplasty (artificial disc replacement)
• Cervical laminectomy or discectomy
• Corpectomy

Recovery

Following surgery, your neck may feel stiff or sore, and you may find it uncomfortable to sit or remain in one position for extended periods. Activities such as lifting, bending, or twisting may be restricted during the initial recovery period to avoid placing unnecessary strain on the neck and spine. Pain medication is commonly prescribed to assist with post-operative discomfort.

Recovery varies depending on the individual patient and the type of surgery performed. As a general guide, patients can expect:

• A hospital stay of approximately three to five days
• Avoidance of heavy lifting during the early stages of recovery, with gradual progression of activity as advised
• Time away from work to allow for healing and recovery
• A temporary return to work on modified or restricted duties
• Restrictions on driving for approximately four to six weeks, depending on recovery progress
• Avoidance of swimming for four to six weeks
• Physiotherapy and rehabilitation, as required
• Ongoing pain management, if necessary

Dr Tollesson will provide specific recovery recommendations based on the procedure performed and your individual circumstances.