Cervical Stenosis and Myelopathy

Cervical stenosis and myelopathy often require surgery. That's because untreated, continued compression of the spinal cord may lead to permanent damage.

Cervical stenosis is a condition that involves the narrowing of the space occupied by the spinal cord and exiting spinal nerves. As the space available for these structures diminishes, the spinal cord or outward-running spinal nerves may be compressed. If the compression occurs at the spinal cord, the condition is called "myelopathy."

Compression of the spinal nerves may result in radicular pain, which radiates into the shoulder, arm and fingers. This may be accompanied by numbness and weakness in one or both arms. Other symptoms can include loss of balance, headaches, loss of vision and difficulty swallowing or performing delicate tasks with the hands. Occasionally, bowel and bladder movement will also be affected.

Diagnosis may involve radiologic tests such as an X-ray, CT scan, MRI or myelogram. These tests can assist the physician in finding the exact location of the spinal cord compression, making treatment more effective.

Surgery is often required to decompress the spinal cord as a result of progressive cervical myelopathy. Decompression surgery may require removal of the cervical disc or vertebral body. Usually, this is performed from the front of the spine using a surgical microscope. Decompression of the spine from the back, involving a laminectomy or laminoplasty, may be required if multiple segments of the spinal column are involved. A laminectomy involves removing the lamina, the bone covering the back of the spinal cord. Laminoplasty involves opening the lamina like the cover of a book, in order to let the spinal cord expand.

Recovery is often unpredictable, and is mainly determined by the amount of spinal cord compression and the length of time it has been compressed.