Cervical Spondylotic Myelopathy Overview

Cervical spondylotic myelopathy (CSM), also known as spinal cord compression, is a condition of the neck in which wear and tear over the course of time leads to a narrowing of the spinal canal.

What Causes Cervical Spondylotic Myelopathy?

As neck pain is commonly caused by soft tissue (muscle, ligaments and nerves) abnormalities resulting from wearing over time or injury, CSM may be attributed to conditions including:

  • Cervical disc degeneration: Also known as a herniated disc, cervical disc degeneration occurs when the soft center of the cervical disc bleeds out through the tough exterior, putting pressure on the spinal column.
  • Inflammatory diseases: Diseases such as rheumatoid arthritis destroys the cartilage in the joints of the neck.
  • Injury: Due to the flexibility of the neck and its support of the head, the neck is extremely prone to injury in situations such as a motor vehicle accident (MVA), household fall or sports injury. While most neck injuries affect the muscles and ligaments, severe injuries like a fracture or dislocation of the neck may cause severe damage to the spinal cord, causing paralysis.
  • Other: In some cases, infections, tumors or other abnormalities of the spine and its components can be the cause of CSM.

Symptoms of Cervical Spondylotic Myelopathy

The spinal cord is the main pathway of nerves between the brain and the body. When the cord is compressed, symptoms may appear including:

  • Difficulty walking due to a loss of balance or a wide-based gait
  • Lack of coordination for simple tasks such as buttoning clothing or self-feeding
  • Loss of bladder or bowel function
  • Neck pain and stiffness
  • Tingling and numbness
  • Weakness in the limbs, resulting in difficulty with lifting or dropping things

How Is Cervical Spondylotic Myelopathy Diagnosed?

After taking a thorough medical history and history of symptoms, Dr. LaRocca will perform a physical examination to look for:

  • Atrophy: Shrinking and deterioration of the muscles
  • Muscle weakness
  • Gait abnormalities
    Irregular reflexes: Poor or uncommon reflexes such as hyperflexia, or an overactive reflex
  • Diagnostic imaging may also be recommended including:
    • Magnetic resonance imaging (MRI): This test is ideal for examining the soft tissues of the body for damage or abnormalities, including compression of the spinal cord.
    • Myelogram: A myelogram is a special computed tomography (CT) designed specifically to show more detailed cross-section images using injected dye to enhance the outline of the spinal cord.
    • X-ray: X-rays are used to examine the alignment of the neck.

What Treatments Are Available For Cervical Spondylotic Myelopathy?

At New Jersey Neck & Back Institute (NJNBI), spine surgeon Dr. Sandro LaRocca our dedicated team provides a variety of surgical and non-surgical options for managing CSM, including:

  • Anterior cervical corpectomy and fusion
  • Anterior cervical discectomy and fusion
  • Cortisone injections
  • Exercise
  • Laminectomy/fusion
  • Non-steroidal anti-inflammatory medications (NSAIDs)
  • Soft collars