Treating Cervical Spondylotic Myelopathy

SpondylolisthesisCervical spondylotic myelopathy (CSM) is a neck condition we treat at DFW Center for Spinal Disorders. CSM is a neck condition that arises when the spinal cord becomes compressed due to wear and tear that naturally affects the spine as we age. CSM is common in patients over 50.

Because the spinal cord carries nerve impulses throughout the body, patients with CSM can have a variety of symptoms. These can involve anything from weakness and numbness in the hands and arms, loss of balance and coordination, to general neck pain, all stemming from the interruption of the normal flow of nerve impulses through the spinal cord.

What causes spondylotic myelopathy?

As we age, various degenerative changes occur in the spine. These changes are often the result of arthritis, in this case known as spondylosis. These changes aren’t unusual — nearly half of everyone over 50 have worn spinal disks that don’t cause painful symptoms. In some, however, they cause CSM.

Bone spurs are one cause of CSM. As we age, our spinal disks lose height and begin to bulge outward. They lose water content, begin to dry out, and become stiffer. This makes them settle/collapse and lose height.

As the disks become thinner the vertebrae are close together. As a response, the body builds bone around the disk to strengthen it. These are bone spurs, and they make the spine stiffer and can narrow the spinal canal, compressing the spinal cord.

Herniated disks also lead to CSM. When a disk herniates, due to injury or degeneration with age, its jelly-like center pushes against its outer ring, sometimes pushing through the lining. When a disk bulges, it puts pressure on the spinal cord.

Symptoms of CSM

Symptoms related to cervical spondylotic myelopathy develop slowly, but at some point CSM can worsen rapidly. These are typical symptoms:

  • Tingling or numbness in the arms, fingers, or hands.
  • Weakness in the muscles of the arms, shoulders, or hands. Grasping items may become difficult.
  • Imbalance and coordination problems. You don’t have a spinning sensation, but your body simply feels unable to follow through with what you are trying to do.
  • Loss of fine motor skills, such as handwriting, buttoning a shirt, picking up coins, or feeding yourself.
  • Neck pain and stiffness.

Treating CSM

At DSW Center for Spinal Disorders, our initial treatments for CSM are nonsurgical. The goal here is to decrease pain and improve your ability to perform daily activities.

Nonsurgical treatments include:

  • Physical therapy — We try to increase flexibility and to strengthen the neck muscles. We may even use some traction to gently stretch the joints and muscles of the neck.
  • Medications — Nonsteroidal anti-inflammatory medications such as ibuprofen and naproxen, oral corticosteroids, epidural steroid injections, and short-term use of narcotic pain relievers may be used.
  • Soft cervical collar — We may put you in a padded ring that wraps around your neck. This allows the muscles of your neck to rest and it limits neck movement. This is a short-term solution, because long-term use decreases the strength of the neck muscles.

Surgical treatment

If nonsurgical methods don’t work to stop the progression of CSM, we may need to use surgery to address the condition. Surgeries for CSM range from anterior (front of the spine) surgeries to posterior (back of the spine) surgeries or possibly both. The goal is to prevent progressing weakness that could eventually lead to paralysis.

If you think you have some of the symptoms of CSM, call us at DFW, 817-916-4685, and let’s examine you.

Posted in: Spondylolisthesis

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