Cervical myelopathy: Causes, symptoms, diagnosis and treatment

By Cristiano Antonino On Jun 1, 2023

The medical term “cervical myelopathy” is used to indicate pathologies affecting the first part of the spinal cord

This group includes cervical spinal stenosis, diseases of the blood vessels that supply the cervical spinal cord, cervical myelitis and all injuries of traumatic origin affecting the cervical spinal cord.

Cervical myelopathy: what is it?

Cervical myelopathy is a medical term used to refer to a disease of the spinal cord located between the first seven vertebrae of the spine.

The list of cervical myelopathies includes all forms of myelitis, i.e. inflammation of the spinal cord, episodes of cervical spinal stenosis, lesions of the cervical spinal cord with traumatic origin and cervical vascular myelopathies, i.e. vascular diseases affecting the vessels supplying the cervical spinal cord.

The most common cervical myelopathy is cervical spinal stenosis, a condition that affects the cervical spine and cervical spinal cord, resulting in narrowing of the spinal canal and subsequent compression of the spinal cord.

The word myelopathy comes from combining “myelo”, a term used in medicine to refer to the spinal cord, and “patia”, which means disease. “Cervical” instead indicates that it refers to the neck area.

The term “cervical myelopathy” therefore literally means “disease of the cervical spinal cord”.

Cervical myelopathy: the causes

The causes of cervical myelopathy can be varied.

Often this pathology is associated with cervical spondylosis, a medical condition that causes a gradual degeneration of the cervical vertebrae, favored by some predisposing factors such as advanced age, neck trauma and obesity.

Cervical myelopathy can also be linked to cervical spinal tumors, rheumatoid arthritis, or cervical disc herniation.

In some patients, the origin of the pathology is a congenital malformation such as narrowing of the spinal canal.

Risk factors for cervical myelopathies include infections affecting the spinal cord, such as poliomyelitis, atherosclerosis, which can cause an abnormal blood supply, autoimmune diseases, such as systemic lupus erythematosus, Sjogren’s syndrome, neuromyelitis optica and multiple sclerosis. The presence of neck trauma in the past and the appearance of cervical spinal tumors also have an impact.

Cervical myelopathy: symptoms

Among the first symptoms of cervical myelopathy we find a sense of stiffness and pain in the neck, often accompanied by discomfort that spreads to the shoulders and back.

Patients with this pathology present a sense of widespread weakness in the muscles of the lower and upper limbs, muscle atrophy and a sensation of numbness in the face.

Among the symptoms there are also urinary and intestinal disorders, as well as impaired motor skills, accompanied by muscle spasms and instability.

Cervical myelopathy: the diagnosis

To diagnose cervical myelopathy it is essential to identify the cause of the pathology.

This can be done by analyzing the patient’s symptoms, through an accurate anamnesis accompanied by radiological examinations such as myelography, CT scan of the spine and nuclear magnetic resonance of the spine.

Often blood tests, lumbar punctures and a neurological examination are also prescribed.

The diagnostic process, often very detailed, allows you to exclude pathologies with similar symptoms to arrive at a precise diagnosis.

Cervical myelopathy: the therapy

Cervical myelopathy is treated differently depending on the underlying cause and the severity of the symptoms.

In the case of cervical myelopathy associated with a spinal cord injury, the treatments, unfortunately, guarantee only limited effects since it is an irreversible condition.