GREENBERG SPINE | Minimally Invasive Spine Surgery
HANDOUT #8: CERVICAL MYELOPATHY
WHAT IS CERVICAL MYELOPATHY?
Cervical myelopathy means the spinal cord in your neck is compressed, causing cord dysfunction. This is different from radiculopathy (single nerve root).
Symptoms (May Affect BOTH Arms and Legs)
Upper extremity:
- • Arm/hand pain, numbness, weakness
- • Clumsiness, difficulty with fine motor tasks
- • Deteriorating hand function
Lower extremity:
- • Leg weakness or gait imbalance
- • Difficulty walking or stairs
- • Stiffness
- • Spasticity
Overall:
- • Balance problems
- • Difficulty with coordination
- • Can progress if untreated
Why It Matters
Cervical myelopathy is more urgent than radiculopathy because prolonged spinal cord compression can cause PERMANENT neurological damage. Earlier intervention often better than late intervention.
Diagnosis
- • MRI shows cord compression and signal changes
- • Neurological exam shows multi-level findings
- • EMG may show cord involvement pattern
Conservative Treatment
- • Limited success (30-40%)
- • Physical therapy
- • NSAIDs
- • Careful activity modification
- • May not stop progression
When Surgery Indicated
- • Progressive symptoms
- • MRI evidence of cord compression with symptoms
- • Most cases benefit from surgery
- • Earlier surgery may prevent permanent damage
MIS Surgical Options
MIS ACDF (single or multilevel)
- • Small incision decompression + stabilization
- • Success rate: 80-90%
- • Recovery: 4-6 weeks
Cervical Laminoplasty
- • Keeps motion, decompresses cord
- • Motion-preserving approach
- • Recovery: 4-6 weeks
Laminectomy
- • Less invasive than open
- • Removes lamina for cord decompression
- • Recovery: 4-6 weeks