Enlarging the Treatment Options for Cervical MyelopathyPressure on the spinal cord from a protruding disc or other cause can be serious. In the neck, this condition is called cervical myelopathy. If it gets worse, the patient can end up with major problems. There can be weakness that never gets better, bowel or bladder problems, and other nervous system symptoms.
Degeneration is the most common cause of cervical myelopathy. This cause of pressure on the spinal cord in the neck is called spondylotic cervical myelopathy. In the past, it has been common for doctors to recommend surgery for mild to moderate symptoms arising from this condition. The operation is designed to get the pressure off the spinal cord. Mounting research is calling this method into question when the condition is mild to moderate and isn't getting worse.
A group of doctors in the Czech Republic wondered if surgery is a better choice when viewed years later. They followed patients for three years and still didn't see a better result with surgery than without. This doesn't mean that surgery for this condition is never needed. Surgery is still the number one choice in cases where the opening for the spinal cord is too small, or where symptoms are severe or worsening.
Doctors have entered a time when it is vital to match the right treatment for each condition they see. Better surgical results come from selecting patients carefully before recommending surgery.
Zdenek Kadanka, MD, PhD, et al. Approaches to Spondylotic Cervical Myelopathy. Conservative Versus Surgical Result in a 3-Year Follow-up Study. In Spine. October 15, 2002. Vol. 27. No. 20. Pp. 2205-2211.
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