Houston Scoliosis and Spine Institute

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What Is Causing My Neck Pain?

If you are experiencing neck pain, it may also be accompanied by other problems. You may have trouble balancing normally and you may also experience handwriting problems. These are signs that you may have a condition called cervical myelopathy. This means that something is pinching your spinal cord. If anything places abnormal pressure on the spinal cord in the cervical spine, which is located in the neck, it can result in neck pain and neurological.

Instead of the pain being directly linked to one nerve root, the effects of a pinched spinal cord can be felt at any point below the area where the abnormal pressure is located. That is why neck pain is not the only problem you may be facing as a result of cervical myelopathy. There are several reasons why your spinal cord may be pinched. It is simply the result of the reduction in the space that the cord needs to function properly.


How Did I Get Myelopathy?

First Possibility: Cervical Stenosis

Spinal diagram

Cervical spine showing degeneration and spinal stenosis

Cervical stenosis is a degenerative condition wherein the spinal column in the neck is abnormally narrow, which causes it to pinch the spinal cord, resulting in myelopathy. In some cases, patients are born with a narrow spinal canal, but more often it is a disease that manifests itself as you age. If you are over the age of 50, the normal wear and tear that your body undergoes may cause cervical stenosis.

Cervical stenosis is often accompanied by a history of neck injuries, and you may have suffered a trauma to your cervical spine months or years before you noticed your current neck pain and neurological difficulties. Stenosis may also be accompanied by bone spurs, which can create additional problems for your spinal cord as well as the nerve roots that branch off from it.


Treatment for Cervical Stenosis

Non-surgical treatments are the first line of defense against cervical stenosis. The first goal of treatment is to relieve pain, so your doctor may recommend over the counter medication or may prescribe something stronger. Besides pain relief, the medication may include anti-inflammatory drugs. You may be put on bed rest until the pain subsides.

A hard plastic neck brace or a soft cervical collar may also be necessary to make sure that your neck remains stable during this time of rest. However, the second goal of treatment is to get you back to living a normal life, complete with the daily activities that you enjoy. In order to get to this point, you may need physical therapy to build up your muscles.

A therapist will guide you through exercises that promote muscle strength, extension, and flexion. This will help you regain a flexible, mobile, and stable cervical spine. The exercises can also help you to build endurance. By the end of therapy, the goal is to be able to move beyond using a collar or brace and to be able to have a stable neck without those additional supports.

If these treatments do not relieve your pain or you cannot regain your fine motor skills and balance even after exhausting these conservative methods, surgery may be necessary. The goal of surgery is also to relive pain and regain your activity. An additional goal for this type of surgery is to decompress the spinal column so that your spinal cord will not be under extreme pressure.

The main form of surgery that is recommended by spinal specialists for cervical stenosis is a decompressive laminectomy. The surgeon will make an incision in the back of the neck, which is known as a posterior approach. This will expose the spinal column and especially the roof (or laminae) of the vertebrae. These laminae will be carefully cut out from the rear of the vertebrae and removed, allowing the spinal cord to expand in a sufficient amount of space.

During this surgery, the surgeon may also remove bone spurs from behind the nerve roots and the spinal cord in order to provide additional decompression and relief. If more than one level of the spine requires surgery, then a fusion may also be required to finish the process. This is because the spine may not be stable after a section of it has been removed.

If that is the case, your surgeon may insert a bone graft to provide additional stability. That graft will fuse to the vertebrae during your recovery as your body heals itself. In addition, instrumentation may be needed for extra support. This may come in the form of implanted rods, screws, hooks, or plates that will support your cervical spine as it heals.


How Did I Get Myelopathy?

Second Possibility: Cervical Spondylosis

Cervical spondylosis is a form of arthritis in the neck. It occurs when the vertebral discs dry up and shrink, causing the vertebrae to move together and pinch the spinal cord. It may also be accompanied by bone spurs. For more information about the condition as well as a discussion of treatment options:

Watch a Video About CERVICAL MYELOPATHY