Cervical Myelopathy

Cervical myelopathy is a condition caused by compression of the spinal cord in the neck. It is most commonly the result of age-related wear and tear (cervical spondylotic myelopathy) but can also be caused by disc herniations, trauma or tumors. Progressive cord compression can lead to significant neurological deficits and typically requires surgical decompression.

What Is Cervical Myelopathy?

Cervical myelopathy refers to the clinical syndrome of spinal cord dysfunction resulting from compression in the cervical spine. As the spinal canal narrows due to degenerative changes—such as osteophytes, ligamentum flavum hypertrophy or disc bulging—the spinal cord becomes squeezed. This compression disrupts the transmission of nerve signals between the brain and the rest of the body.

At a Glance

Cervical myelopathy is spinal cord compression in the neck, most often due to degenerative changes
Symptoms include loss of fine motor skills, gait instability and numbness or weakness in the extremities
MRI is the gold standard for diagnosis and evaluating the severity of cord compression
Conservative treatment is generally ineffective for progressive myelopathy
Surgical decompression (anterior, posterior, or combined) is the definitive treatment to halt progression

Symptoms

Diagnosis

MRI of the cervical spine — the gold standard; shows the exact location and degree of spinal cord compression and any hyperintense signal within the cord indicating damage.
CT scan — provides detailed bone anatomy, useful for identifying calcified discs or ossification of the posterior longitudinal ligament (OPLL).
X-rays — flexion/extension views to assess spinal stability and alignment.

Types

Treatment

Anterior Cervical Discectomy and Fusion (ACDF) — removing the disc and bone spurs from the front of the neck and fusing the vertebrae.
Cervical Corpectomy — removing the vertebral body and discs to decompress the cord from the front, followed by reconstruction.
Laminectomy or Laminoplasty — removing or creating a hinge in the back of the vertebrae (lamina) to expand the spinal canal from the posterior approach.

Outcomes

Treatment	Primary Goal	Notes
Anterior Decompression (ACDF/Corpectomy)	Halt disease progression	Highly effective for focal anterior compression
Posterior Decompression (Laminectomy/Laminoplasty)	Expand spinal canal	Preferred for multi-level compression in patients with preserved cervical lordosis

References

Our Specialists

Mohamad Bydon, MD

Neurosurgery

Timothy Witham, MD

Neurosurgery

Martin Herman, MD, PhD

Neurosurgery

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