Neurosurgery

Cervical Decompression

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What do I have?

Cervical myelopathy and/or radiculopathy are conditions caused by compression of the spinal cord (myelopathy) and/or nerve roots (radiculopathy) as they pass through the cervical vertebrae (of the neck). Symptoms may include neck pain, stiffness, and decreased ability to move the neck. Because all the nerves that supply the body pass through this region, in addition to symptoms in the neck, patients may experience symptoms referable to compression of nerves passing through the cervical spinal canal. These include weakness and numbness of the arms and legs, pain or tingling sensations that travel down one or both arms, difficulty with walking, and bowel and bladder dysfunction.

What does it do?

Degenerative changes in the cervical vertebrae and surrounding soft tissues (ligaments, intervertebral discs, joint capsules) cause narrowing of the spinal canal where the spinal cord itself passes, as well as the openings that allow passage of nerve roots as they exit the spinal cord and travel to other parts of the body. Compression of these nervous system structures leads to the previously mentioned symptoms – namely pain, weakness, numbness, difficulty walking, and bowel and bladder dysfunction – which become progressively worse over time. If left untreated, cervical myelopathy can progress to paraplegia (inability to use the legs).

How long have I had it?

The degenerative (arthritic) changes of the cervical spine that cause myelopathy and/or radiculopathy take years to develop and are the results of the ‘wear and tear’ on the neck caused by bearing the weight of the head (on average 10 pounds – the equivalent of a bowling ball) for years. Poor posture, overuse, and trauma (for example whiplash injury from a motor vehicle accident) are also contributing factors. On occasion, patients with cervical myelopathy or radiculopathy will have a sudden worsening of their symptoms. This may be caused by a sudden movement (herniation) of a part of one of their intervertebral discs (the soft tissue shock absorbers between your vertebrae) that causes increased compression of the spinal cord or one of its nerve roots. Furthermore, some patients with narrowing of the spinal canal in the neck, also known as cervical stenosis, may have minimal symptoms from the condition. However, an unfortunate number of these patients may come to medical attention for their cervical stenosis after a fall or some other injury that resulted in over-extension of their neck and a sudden decrease in the ability to use their arms. This condition, known as a spinal cord contusion (or bruising), is caused by increased pressure on the spinal cord within a narrow spinal canal, leading to loss of blood supply and injury to the nerves within the spinal cord.

Can it be cured?

Although there are several very good nonsurgical and surgical treatment options available to relieve the symptoms of cervical myelopathy and radiculopathy, there is no cure, per se, for the degenerative changes in the cervical spine that caused the symptoms. Treatment, in the case of both nonsurgical as well as surgical, is targeted at the relief of the symptoms caused by the cervical stenosis.

What caused it?

As previously mentioned, the degenerative, arthritic changes in the vertebrae and soft tissues of the neck lead to cervical stenosis, cervical myelopathy and radiculopathy. These changes take years to develop and are caused by the usual ‘wear and tear’ on the spine. Occasionally a sudden injury, from over-extension of the neck, overexertion, or whiplash from a motor vehicle accident, can cause sudden worsening of a patient’s symptoms.

How is it treated?

Treatment for cervical stenosis, cervical myelopathy and radiculopathy at Rochester Neurosurgery Partners is focused on the relief of symptoms caused by the condition, in particular pain relief, decreased numbness or tingling sensations, and restoring of muscle function. Patients in particular who develop progressive loss of strength and muscle function as a result of cervical stenosis may be good candidates for surgical cervical decompression. The primary goal of cervical decompression is to prevent further progression of these debilitating symptoms, especially weakness and eventual paralysis. Although some patients experience tremendous relief from many of the symptoms of their cervical stenosis after cervical decompression surgery (neck and arm pain, numbness, tingling), other patients will experience lingering effects of these symptoms even after decompressive surgery. This is often due to the degenerative changes within their spine, which cervical decompression cannot reverse, and chronic nerve damage from compression over time.

What is special about our approach to treating this condition?

Rochester Neurosurgery Partners has one of the largest collections of spine specialists in the area who offer a comprehensive range of surgical options for the treatment of cervical stenosis, myelopathy, and radiculopathy, including minimally invasive techniques and operations to fuse the spine in cases of cervical spine instability. Appropriate diagnostic imaging (for example MRI of the Spine) and outpatient consultation with one of our experts will be the best way to find out what approach is right for each patient.

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