Out-of-state? Free MRI review + telehealth consult before you travel4.9 ★ · 619 Google reviewsBoard-certified — American Board of Orthopaedic SurgeryMinimally invasive, same-day spine surgery in Beverly HillsCall (424) 217-7463
Out-of-state? Free MRI review + telehealth consult before you travel4.9 ★ · 619 Google reviewsBoard-certified — American Board of Orthopaedic SurgeryMinimally invasive, same-day spine surgery in Beverly HillsCall (424) 217-7463
Cervical myelopathy is pressure on the spinal cord in the neck. It often starts quietly, with clumsy hands or unsteady walking, and it deserves prompt attention.
Cervical myelopathy is compression of the spinal cord in the neck. It is different from a pinched nerve. When one nerve root is squeezed, symptoms follow a single path down one arm. When the cord itself is squeezed, the signals running to both arms and both legs are affected, so hand coordination, balance, and walking can all change.
The neck is the most common place for this to happen, usually because of age-related changes: discs that bulge backward, bone spurs, and thickened ligaments that slowly narrow the canal. Early signs are easy to miss or blame on aging. Dropping things, fumbling with buttons, or feeling unsteady on your feet are typical. Dr. Melamed treats cervical myelopathy as time-sensitive, because the spinal cord tolerates long-standing pressure poorly and nerve damage that has already set in may not fully recover.
✓Clumsy hands, dropping objects, or trouble with buttons and handwriting
✓Numbness or tingling in the hands, often in both
✓Unsteady walking or a feeling of poor balance
✓Neck pain or stiffness (not always present)
✓Electric-shock sensations down the spine when bending the neck forward
✓In advanced cases, changes in bladder or bowel control
What causes Cervical Myelopathy?
Disc herniation or bulging discs pressing on the cord
Bone spurs and arthritis narrowing the spinal canal (cervical spondylosis)
Thickening or calcification of the ligaments around the cord
Ossification of the posterior longitudinal ligament (OPLL)
Injury, instability, or a slipped vertebra in the neck
Less often, rheumatoid arthritis, tumors, or infection
How is Cervical Myelopathy diagnosed?
Dr. Melamed looks for the signs that point to the spinal cord rather than a single nerve: changes in hand function, gait, balance, and reflexes. An MRI of the cervical spine is the key test. It shows where the cord is compressed, how tightly, and what is doing the pressing. A CT scan helps when bone or calcified ligament is part of the problem, and it guides the surgical plan.
How is Cervical Myelopathy treated?
Once myelopathy is established, it rarely improves with therapy or injections alone, because the problem is mechanical pressure on the cord. Mild cases with few symptoms are sometimes watched closely. Progressive or significant myelopathy is generally treated with surgery to take pressure off the cord and stop further decline.
Most patients need decompression without fusion. When the compression comes from behind, Dr. Melamed can often relieve it through minimally invasive outpatient procedures such as microlaminotomy, medial facetectomy, and microforaminotomy, with no rods or screws. When it comes from the front, which is more common, he uses a minimally invasive anterolateral approach he developed, performed under a high-powered microscope with live CT-guided navigation and a non-narcotic recovery plan. Fusion is reserved for spines that are unstable or need realignment.
It is a condition to have evaluated soon, not a routine stiff neck. Symptoms can progress, and function is easier to protect when pressure comes off the cord before deficits become severe. Rapidly worsening weakness, falls, or any change in bladder or bowel control should be assessed urgently.
Can physical therapy fix cervical myelopathy?
Therapy can help with neck pain and conditioning, but it cannot remove the disc, bone spur, or ligament pressing on the cord. Mild, stable cases are sometimes monitored. When symptoms progress, relieving the pressure generally requires surgery.
Do I need rods and screws?
Most patients do not. Dr. Melamed's approach favors decompression alone, through minimally invasive techniques, and saves fusion for necks that are unstable or need realignment.
Will my symptoms go away after surgery?
The first goal of surgery is to stop the decline. Many patients also regain some function over the following months. How much depends on how severe and how long-standing the compression was, which is why earlier evaluation matters.
