Cervical Myelopathy (Spinal Cord Compression) | Elite Pain & Health – Oklahoma

Cervical Myelopathy (Spinal Cord Compression)

If you’ve noticed that your hands are clumsier, your balance is off, or your neck pain has worsened, these may be signs of something more serious than simple arthritis. Cervical myelopathy occurs when the spinal cord itself becomes compressed within the neck typically from advanced degenerative changes, disc bulges, or bone overgrowth.

At Elite Pain & Health, Dr. Keley John Booth focuses on early recognition, precise imaging, and evidence-based, minimally invasive management to prevent permanent spinal cord damage. Not all spinal cord compression requires surgery, but it always requires prompt expert evaluation.

Why It Happens

Your spinal cord is the main communication highway between your brain and body. It runs through the central spinal canal, surrounded by bone, discs, and ligaments. When that canal narrows a condition called cervical spinal stenosis the spinal cord can become compressed or irritated.

Common causes of cervical myelopathy include:

• Degenerative changes (cervical spondylosis) leading to thickened ligaments and bone spurs

• Disc herniation or bulge pressing directly on the cord

• Congenitally narrow spinal canal

• Trauma or whiplash injury worsening pre-existing narrowing

• Post-surgical scarring or instability from prior cervical fusion

• Inflammatory or autoimmune conditions (less common)

Over time, chronic pressure decreases blood flow and oxygen to the spinal cord, damaging the delicate nerve fibers that control movement and sensation.

What It Feels Like

Cervical myelopathy symptoms often develop gradually, which is why it can go unnoticed until function is affected.

Typical symptoms include:

• Neck stiffness or deep ache

• Weakness or clumsiness of the hands (difficulty buttoning shirts, handwriting changes)

• Loss of fine motor coordination

• Numbness or tingling in arms or legs

• Unsteady walking, balance problems, or frequent tripping

• Heaviness or fatigue in arms or legs

• Shooting “electric shock” sensation down the spine when bending the neck (Lhermitte’s sign)

• Bladder or bowel urgency in severe cases

Even mild myelopathy requires careful monitoring, as nerve damage can progress silently.

How It’s Diagnosed

Because symptoms can mimic other conditions like peripheral neuropathy or radiculopathy, accurate diagnosis requires high-resolution imaging and a focused neurologic exam.

Dr. Booth’s stepwise diagnostic approach includes:

• Comprehensive physical and neurologic evaluation – tests for reflexes, gait, balance, and fine motor coordination

• MRI of the cervical spine – to visualize cord compression, disc herniation, or canal narrowing

• Digital Motion X-ray (DMX) – assesses instability or ligamentous laxity that worsens narrowing

• CT myelography – occasionally used for surgical planning or when MRI is contraindicated

• Electrodiagnostic testing (EMG/NCS) – if additional peripheral nerve issues are suspected

MRI findings may reveal cord indentation, myelomalacia (softening), or signal changes all indicators of spinal cord stress that guide treatment urgency.

Conservative Treatment

Not all myelopathy cases need immediate surgery. For mild to moderate compression without progressive weakness, Dr. Booth uses a structured, image-guided, and regenerative approach to calm inflammation, improve stability, and prevent worsening compression.

Non-surgical management may include:

• Image-guided epidural or selective nerve root injections – to reduce inflammation and pain from nerve irritation

• Facet or medial branch blocks – when joint hypertrophy contributes to canal narrowing

• Regenerative orthobiologic therapy (PRP or cell-based injections) – to strengthen supportive ligaments and slow degenerative progression

• Physical therapy and posture optimization – gentle, supervised motion, cervical traction, and core strengthening

• Medication management – nerve-calming agents, mild anti-inflammatories, or short-term muscle relaxants

Dr. Booth carefully monitors neurologic function; if weakness or coordination declines, surgical referral is considered promptly. The goal is always to preserve motion and protect the spinal cord while avoiding unnecessary fusion whenever possible.

When Surgery Becomes Necessary

Surgery is reserved for patients with progressive weakness, balance loss, or imaging evidence of significant spinal cord compression.

Typical procedures include:

Anterior Cervical Discectomy and Fusion (ACDF)

Cervical Laminoplasty

or Laminectomy

Posterior decompression

and fusion

Even when surgery is required, pre- and post-operative collaboration with a pain management specialist like Dr. Booth helps minimize recovery time, improve spinal stability, and prevent adjacent-level stress.

When to Seek Immediate Care

You should seek urgent evaluation if you experience:

• Rapidly worsening arm or leg weakness

• Frequent tripping or balance loss

• Numbness or tingling in both arms or legs

• Loss of bladder or bowel control

These symptoms may indicate active spinal cord injury and require immediate assessment.

Take the Next Step

If you’re noticing worsening hand coordination, gait imbalance, or persistent neck stiffness, don’t ignore it. Early evaluation can prevent permanent spinal cord injury.

Dr. Booth and the Elite Pain & Health team specialize in early, image-guided, non-surgical management of cervical spinal cord compression helping patients stay active, safe, and independent.