myelopathy

If you or a loved one has been diagnosed with cervical spondylotic myelopathy (CSM), it's time to learn more about the disease and start weighing your options. CSM is a devasting disease that impacts your ability to interact with the world around you and to enjoy a quality, pain-free life.

Let's explore what this condition is, what causes it, and treatment options to help you live a higher quality life.

What Is Cervical Spondylotic Myelopathy (CSM)?
CSM is a degenerative cervical spine disorder. Although the exact number of cases of the CSM is unknown, the medical community agrees that this is the most common spinal cord disorder in people over the age of 55. CSM is a compression of the spinal cord in the neck. The spine is an important part of your neurological system, the system that transfers messages throughout the body. Because of this, those with CSM may experience symptoms in places other than the neck, as we'll explain further below.

Who Gets Cervical Spondylotic Myelopathy?
Anyone can get CSM. The disease most often appears in those over 55. Men are more likely than women to suffer from the condition.

What Causes Cervical Spondylotic Myelopathy?
The neck portion of your spine is referred to as the cervical spine. It contains 7 spinal bones, called vertebrae. Each of these bones is stacked up on the one below in a slight curve. While these bones are an important framework for your body, they're also flexible in relation to each other. When you bend forward or move your head side to side, these bones realign themselves in a curved position to accommodate the movement. A disk is a shock absorber present in-between the bones. You have one between each bone on your spine. These disks keep the bones from rubbing against each other as you move. The disks are also incredibly important, because if the spine were bone to bone, your spinal cord and other nerves would be pinched between the bones and thus be unable to transport messages throughout your body. Surrounding the spine are ligaments. A ligament is a thick, fibrous, connective tissue that attaches one bone to the next -- with the disks between. As we age, the bones, disks, and ligaments in and around our spine change. The disks may thin, creating bone spurs. Inflammatory conditions like Rheumatoid Arthritis can attack the disk cells, eating away at them. Degenerative disk disease is one of the leading causes of CSM. This is caused by a natural drying out of the disks as we age. Couple this with things like injury and intense sports that can cause inflammation or even disk tears and it spells trouble. All these events speed up the degeneration. Without the disk cushions between bones, the ligaments can become tighter, forcing the bones closer together, which blocks nerve signals.

What Are the Symptoms Of Cervical Spondylotic Myelopathy?
CSM is a progressive disease. Patients may experience mild symptoms at first that lead to much more severe experiences.

Now that we have a better understanding of the anatomy of the cervical spine, these symptoms will make perfect sense. These include:

  • Tingling and numbness in hands and fingers. If you envision those bones pressing on your spinal cord and nerves, it's easy to understand why this happens.
  • Arm and hand muscle weakness. Again, the messages can't get through.
  • Imbalance. Unlike Vertigo, where the world feels like it's spinning, in the case of CSM, the world seems very sturdy. Your brain just can't seem to coordinate the muscles to help you stand without falling.
  • Loss of fine motor skills. You may not be able to make a fist or hold a pen or button your shirt.
  • Pain and stiffness in the neck. Without that extra cushioning, you have reduced flexibility and pain as bone collides with bone.

How Does My Doctor Know That I Have CSM?
The first signs may be the symptoms that prompt your doctor to run some tests to determine the cause of these symptoms. If you're having these symptoms, talk with your doctor immediately. If you're in the Hackettstown or Whiting, NJ areas, we're here to help. An X-ray will show the bone structure. The disks won't show up on the X-ray, but the doctor can see if they're compressed or non-existent, based upon how close your spinal bones are to each other. If he/she is not able to glean all the required information from the X-rays, an MRI or CT scan may be ordered. These scans will show soft tissues like disks and ligaments to get the whole picture.

What Are My Treatment Options?
Non-Surgical Treatments
If the symptoms are very mild, then treatment involves reducing the pain and inflammation while strengthening the cervical spine. Non-surgical methods include:

  • A cervical collar - a soft padded collar that you velcro around your neck. Its goal is to reduce pressure so that the disks can heal. Prolonged wearing, however, would weaken neck muscles, so you'll be limited to set hours of wear.
  • Physical therapy - an exercise plan designed and supervised by a physical therapist.
  • Medications

Surgical Treatments
If the condition has progressed, surgery will likely be recommended if you're a good candidate for the procedure. Your doctor will perform a complete evaluation and determine the best procedure for your condition. Then, he/she will work with you to develop a recovery plan for after the procedure. The goal of having surgery is to reduce pain and restore function that may have been lost due to the compressing of the nerves in the spine.

The 4 surgeries for CSM are:

  • Laminoplasty- Creating more space between bones for the spine and nerves by cutting away part of the lamina, a thin, arched piece of bone on the vertebra.
  • Laminectomy- Removal of the back part of the spine
  • Anterior Cervical Diskectomy and Fusion - Removal of damaged disks before fusing the bones together.
  • Anterior Cervical Corpectomy and Fusion - Removal of damaged disks or bone matter before fusing the bones together.

Getting Treatment

Cervical Spondylotic Myelopathy is a progressive disease that can significantly impact your quality of life. If you're experiencing the above symptoms or have been diagnosed with this condition, know that you have options. We're here to help.