Question:I've been told the best treatment for my neck problem is surgery. I've been diagnosed with cervical myelopathy. A laminectomy and fusion of three levels is what the surgeon is recommending. I know a fusion means I won't be able to move my neck. What's the benefit of that?
Answer:Even with a multilevel cervical fusion, you will still have quite a bit of neck movement. You might notice some change when you are looking back over your shoulder or if you try to look under your armpit. Neither one of those motions are essential for everyday activities. Or they can be done with the help of a mirror.
With cervical myelopathy (CM) the spinal cord is being compressed by a narrowing of the spinal canal. The spinal canal is the opening where the spinal cord travels from the skull down to the lumbar spine. CM specifically refers to the location of this problem in the neck region.
Besides pressure on the spinal cord and spinal nerves, CM can also twist or distort the neural tissue. Loss of blood supply from tugging and pulling on the blood vessels can lead to further damage.
Change in the position of the spine can result in pinching of the ligament along the back of the spine when the head and neck are extended. Over time, this has the effect of causing microtrauma to the soft tissues. The condition can get worse and worse.
Surgery to take pressure off the spinal cord also involves lining the bones up and fusing them in a good position. This relieves the pain and stabilizes the neck. Hopefully, the patient also gets increased function with less risk of long-term problems. Left untreated, the condition can progress to the point of irreversible symptoms and even paralysis in some cases.Ricardo J. Komotar, MD, et al. Surgical Management of Cervical Myelopathy: Indications and Techniques for Laminectomy and Fusion. In The Spine Journal. November/December 2006. Vol. 6. No. 6S. Pp. 252S-267S.
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