Cervical Center
Cervical Myelopathy
Cervical myelopathy is a progressive compression of the spinal cord in the neck. It can cause hand weakness, numbness, and difficulty with fine motor skills. Early diagnosis is critical.
Overview
Cervical myelopathy is a condition caused by compression of the spinal cord within the cervical spine. It develops slowly and progressively, often leading to hand weakness and numbness, difficulty with fine motor skills such as buttoning clothes or holding small objects, and dropping items more frequently.
Patients may not immediately notice their decline in hand function. Often, a spouse or close family member is the first to recognize subtle changes. Over time, muscle atrophy in the hands can develop, making symptoms more apparent. If left untreated, cervical myelopathy can progress to walking difficulties.
Patients may adopt a wide based, slow gait to maintain balance and, in severe cases, may experience frequent falls. Causes include a large central disc herniation that compresses the spinal cord and osteophytes from cervical degeneration leading to spinal cord compression. MRI of the cervical spine without contrast is the best way to diagnose cervical myelopathy.
Additional clinical overview content is pending medical review by Dr. Abrahams and the clinical team.
Symptoms
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Causes
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When to see a specialist
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Non surgical treatment options
The Cervical Center works with the team at Spine Options to provide non operative care for patients. Most patients who present with some form of neck pain, upper extremity weakness or numbness, or lower extremity weakness or numbness within the diagnosis of cervical spine disorders will not need surgery. Most symptoms improve over time with conservative treatment.
Physical therapy
We develop personalized physical therapy prescriptions based on your specific needs and refer you to experienced local providers. These programs improve strength, flexibility, and posture, helping to reduce pain, enhance mobility, and promote long term spinal health.
Epidural injections
For patients who may benefit from epidural steroid injections, we provide expert evaluations and referrals to trusted local physicians who specialize in pain management. These injections can reduce inflammation and nerve related pain caused by conditions such as disc herniation or foraminal stenosis, offering relief with minimal downtime.
Medication
Most neck pain improves with non steroidal anti inflammatory agents such as Motrin, Aleve, Advil, and Tylenol. Any patient with numbness or weakness is a more urgent matter and should undergo an MRI of their cervical spine regardless of pain level.
Surgical options
Patients are initially evaluated by a physiatrist to ensure all non surgical options, including physical therapy and non narcotic pain management, are exhausted before considering a surgical solution.
Anterior cervical discectomy and fusion
Anterior cervical discectomy and fusion, or ACDF, is a surgical procedure used to treat patients with a compressed nerve or spinal cord who do not improve with conservative care. If a patient has a compressed spinal cord and exhibits any symptoms, they will most likely need to undergo surgery regardless of their response to conservative care, since conservative care is unlikely to improve the symptoms.
The incision is made in the front of the neck, usually in a horizontal skin fold. The surgeon removes the disc to allow access to the spinal cord and spinal nerves. Once the disc is removed, the surgeon frees the compressed nerve or spinal cord to provide relief. Since there is no disc remaining, the surgeon replaces it with a spacer and secures the spacer with a plating system.
Posterior decompression and fusion
Used for severe, multi level stenosis such as C3-4 to C6-7, where an anterior approach may not be sufficient.
Unlike other spinal conditions, cervical myelopathy rarely improves with physical therapy or conservative care. In most cases surgery is necessary to relieve spinal cord compression, especially when myelomalacia is present.
Recovery
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Sources and further reading
Patient questions
Frequently asked questions
Our clinical team explains Cervical Myelopathy using your history, examination, and imaging. Symptoms vary by nerve or spinal cord involvement. An accurate diagnosis guides whether conservative care or surgery is the safest next step.
Symptoms may include neck or back pain, arm or leg pain, numbness, weakness, or balance changes when the spinal cord is involved. Severity and duration help determine urgency and treatment options.
Evaluation usually includes a neurological examination and MRI. X ray or CT may assess bone alignment. We correlate imaging with your symptoms before recommending injections, therapy, or surgery.
Physical therapy, medication, activity modification, and selective injections are common first steps. We monitor progress over four to eight weeks and escalate only when symptoms persist or neurologic deficits progress.
Seek urgent care for rapidly worsening weakness, loss of bowel or bladder control, saddle anesthesia, or severe pain after trauma. Call (914) 948 3008 for guidance if you are unsure how quickly to be seen.
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Office
Institute For Spine Surgery244 Westchester Avenue, Suite 209
West Harrison, NY 10604
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