Cervical myelopathy results from a narrowing (stenosis) around the spinal cord in your neck. It is usually caused by degeneration and arthritis of the bones, ligaments and joints in your neck. It is also known as cervical spondylotic myelopathy or degenerative cervical myelopathy (DCM).

Froedtert & MCW specialists have experience diagnosing and treating cervical myelopathy. We have developed a unique post-surgical rehabilitation program to manage your recovery and symptoms.

These images show the pinched spinal cord in the neck that is indicative of cervical myelopathy.

Diagnosing Cervical Myelopathy

It can be difficult to diagnose cervical myelopathy because the symptoms often overlap with other neurodegenerative condition symptoms. 

Your doctor will talk to you and perform a physical examination. Early symptoms may be subtle, but a physical exam can pick up signs of spinal cord dysfunction. Your doctor will order an MRI of your neck to confirm the diagnosis. Though early symptoms are sometimes challenging to identify, Froedtert & MCW specialists have experience diagnosing cervical myelopathy and are aware of the diverse symptoms it can present.

We carefully review the MRI findings in conjunction with clinical symptoms. If there is a mismatch, we will evaluate you for other possible causes prior to recommending surgery. 

Cervical Myelopathy Symptoms

You may or may not experience neck or arm pain. Symptoms may progress slowly or rapidly. Cervical myelopathy symptoms include: 

  • Loss of manual, hand dexterity
  • Alterations in gait or gait impairment when you walk
  • Imbalance, unsteadiness and falls
  • Paraesthesia (tingling or pins and needles sensations)
  • Upper limb weakness, numbness
  • Lower limb stiffness, weakness or sensory loss
  • Limb or body pain on one or both sides
  • Autonomic symptoms, such as bowel or bladder incontinence, erectile dysfunction or difficulty passing urine

Cervical Myelopathy Treatment

Depending on your diagnosis, the most common treatment is surgical decompression followed by post-operative therapy and rehabilitation. We take a thoughtful and nuanced approach to surgical treatment.

Monitoring

If you have very mild symptoms, we may start by closely monitoring the pressure on your spinal cord. Therapy can help to manage symptoms in some mild cases.

Spinal Cord Decompression Surgery

If surgery is recommended, we will proceed with the least invasive option, trying to preserve motion and decrease recovery time whenever possible. There are several surgical options for relieving the pressure on the spinal cord, such as: 

  • Laminectomy — Removes part of the vertebra where the spinal cord is pinched
  • Laminoplasty — Opens part of the spine vertebra to increase the space in spinal canal and relieve pressure on the spinal cord. 
  • Posterior cervical decompression and fusion — Approaching from the back of the neck, your surgeon decompresses the spinal cord and adds rods and screws for stability and fusion.
  • Anterior cervical diskectomy and fusion — Approaching from the front of the neck, your surgeon removes part or all of a damaged spinal disk to decompress the spinal cord and adds hardware for stability and fusion.
  • Anterior cervical corpectomy and fusion — Approaching from the front of the neck, your surgeon removes damaged vertebra and disk material (the cushion between the vertebra) to relieve pressure on the spinal cord in your neck.

Post-Surgery Cervical Myelopathy Rehabilitation 

The Froedtert & MCW SpineCare Program has a unique Cervical Myelopathy Rehabilitation Program. The program creates a postoperative recovery program tailored to your needs and designed to address your specific myelopathy symptoms.

You will work with your physical therapist to identify issues with strength, range of motion, dexterity and balance — as well as identifying your goals for recovery. We will address any impairments through a variety of exercises while working with physical therapy.

You can expect to be seen for four to six visits over a period of 6 to 8 weeks. This will vary depending on the degree of patient impairment and your goals. 

The Cervical Myelopathy Rehabilitation Program is available on an outpatient basis (no hospital stay required) and is found at our physical therapy locations, pain locations and SpineCare locations throughout southeastern Wisconsin. Call the location to make an appointment.