Cervical Myelopathy Treatment Options

Cervical myelopathy is spinal cord compression that results in progressive upper and lower extremity weakness and imbalance which affects quality of life. It can occur due to injury, herniated discs, bone spurs, arthritis, and old age. Depending on the area of disc herniation it can present as myelopathy or radiculopathy.

Myelopathy (spinal cord compression) may be mild, moderate or severe. Treatment options depend on the location of the compression and your symptoms. Available treatment options are based on each patient’s needs.

Sometimes the diagnostic process reveals spinal cord compression, but the patient has no or very mild symptoms. In that case your neurologist may recommend regular monitoring. When the MRI shows some evidence of compression and the patient has symptoms of a pinched nerve including pain, numbness and tingling, there is a high likelihood of needing surgical treatment. Left untreated, the numbness and weakness can worsen and become permanent. Treatment options include nonsurgical management, a cervical epidural injection and/or surgery. 

What are the treatment options for cervical myelopathy?

  • Cervical epidural injection. Epidural injections can be helpful for cervical radiculopathy but not for spinal cord compression (myelopathy.)
  • Nonsurgical management. When your symptoms are mild, your Dallas Neurological and Spine specialist may recommend a trial of nonsurgical management. The goal is to decrease pain, stabilize and improve function.

Nonsurgical management typically includes a structured program of physical therapy to improve range of motion, strength, stability and flexibility; avoidance of high-risk activities like heavy lifting and chiropractic manipulation; use of a cervical collar, and medications to relieve pain and inflammation including over-the-counter pain relievers, a short course of oral steroids and other medications.

When nonsurgical management fails to relieve symptoms or symptoms worsen, your neurosurgeon will recommend decompression surgery.

  • Decompression surgery. The goal of surgery is to relieve symptomatic compression on the nerve roots and spinal cord and prevent neurological deterioration. It may involve removal of a compressed disc, bone spurs, and tissues like thickened ligaments causing the compression.

A number of surgical approaches are available with and without the need for spina fusion. Some of these procedures can be performed as minimally invasive decompression surgery. Your Dallas Neurosurgical & Spine expert will advise you not to wait until you have severe symptoms because compression can cause permanent damage.

The decision to proceed with surgery requires a comprehensive discussion with your neurosurgeon. Your surgeon will discuss your options with you based on your symptoms and the severity of your condition.

To learn more contact Dallas Neurosurgical & Spine today to schedule a consultation. We have several convenient locations in Plano, Dallas, and Frisco, TX, to serve you.

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