The first time you drop your coffee cup, it may seem like an accident. But then you have issues buttoning shirts or holding a pen. Perhaps your balance becomes an issue.
You might chalk these up to regular signs of aging, but they’re not. They indicate a serious, but treatable condition: cervical stenosis with myelopathy.
The good news is that you can treat cervical stenosis and prevent the progression of myelopathy with surgery. At Neurosurgeons of New Jersey, we specialize in treating complex spinal cord cases, including cervical stenosis and myelopathy.
In this guide, we’ll help you explore the causes of cervical stenosis, myelopathy and how they can impact your quality of life. We’ll also discuss treatment options that can reduce the pain and discomfort of living with these conditions.
What Is Cervical Stenosis with Myelopathy?
Cervical stenosis is the narrowing of the spinal canal in the neck. Once the narrowing becomes severe enough to injure the spinal cord itself, it leads to a condition called cervical myelopathy. While mild narrowing may cause few or no symptoms at first, this long-term squeezing can interfere with the spinal cord’s ability to transmit signals between the brain and body, often leading to weakness, balance problems, and hand clumsiness that can worsen over time.
Understanding Cervical Stenosis
How does this narrowing happen? Your spinal canal is a protective tunnel that runs through your neck bones (the cervical vertebrae) and houses your spinal cord. Cervical stenosis means the tunnel has narrowed, often due to natural aging, arthritis, bone spurs (growths), herniated discs, or thickened ligaments.
Not all stenosis causes symptoms. Some people can have narrowing without nerve or cord compression. But if the space becomes too tight, it can start to squeeze the spinal cord. That’s when more serious problems can develop, including myelopathy.
What Is Myelopathy?
Cervical myelopathy refers to spinal cord dysfunction or injury. In cervical myelopathy, the damage happens in the neck portion of your spinal cord, which controls movement, coordination, and balance. Unlike nerve root compression, which affects one nerve and usually causes pain or tingling in a specific part of one arm, myelopathy affects the spinal cord itself. This leads to wider and more serious neurological changes that can affect your entire body.
Myelopathy is more than mere pressure. It’s an actual injury to your spinal cord tissue from ongoing compression and reduced blood flow. Over time, this damage can become permanent. Chronic cord compression can lead to inflammation and scarring, ultimately resulting in lost nerve cells inside your spinal cord.
The Connection: When Stenosis Leads to Myelopathy
Cervical stenosis that lasts long enough can start to injure your spinal cord. Because of this slow process, you may mistake your symptoms for normal aging. Early recognition makes a big difference. Timely surgical treatment can stop or even improve neurological decline, while delays increase your risk of permanent disability.
Warning Signs You Shouldn’t Ignore: Symptoms of Cervical Stenosis with Myelopathy
While cervical stenosis with myelopathy develops slowly, its symptoms are distinct, particularly in the hands and balance. Recognizing these warning signs can lead to faster diagnosis and better outcomes.
Early Warning Signs in Your Hands
One of the first cervical stenosis and myelopathy symptoms to watch for is increasing hand clumsiness. You might notice yourself dropping objects or struggling more with buttons or utensils. Perhaps your handwriting is harder to control. Many patients also report numbness or tingling in the fingers or hands. These symptoms often appear long before you notice neck pain.
Balance and Coordination Problems
As the problem progresses, you might feel unsteady on your feet or need to hold onto walls or furniture while walking. Difficulty walking in the dark or on uneven surfaces can also be a red flag for spinal cord compression.
Other Neurological Symptoms
You may notice stiffness or weakness in your arms or legs, leading to a heavy feeling when you move. More advanced cases can even include loss of bladder or bowel control. These are signs of significant spinal cord injury that you shouldn’t ignore.
Progressive Nature of Symptoms
These symptoms usually progress gradually, but sudden or worsening weakness or balance loss should be evaluated by a spine specialist right away.
What Causes Cervical Stenosis with Myelopathy?
Cervical stenosis with myelopathy results from several conditions that cause narrowing of your spinal canal. Age-related changes remain the leading cause, but they’re not the only reason a person may develop cervical stenosis and myelopathy.
Age-Related Degeneration
As we age, the discs and joints in the neck naturally wear down. Degenerative changes like bulging discs or bone spurs can gradually narrow the spinal canal, as can thickened ligaments.
Herniated Discs
A herniated or bulging disc can push into the spinal canal and press directly on the cord. Combined with existing arthritis-related narrowing, this can quickly lead to myelopathy symptoms.
Spinal Instability
Sometimes, instability between vertebrae (like spondylolisthesis) can cause the canal to narrow during movement. This puts additional pressure on the spinal cord.
Other Contributing Factors
Past neck injuries or being born with a naturally narrow spinal canal or other deformities can all increase the risk of developing myelopathy.
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How Is Cervical Stenosis with Myelopathy Diagnosed?
Diagnosing cervical stenosis with myelopathy requires a thorough clinical exam and advanced imaging to confirm where and how severely the spinal cord is being compressed. This helps guide the treatment plan.
Clinical Evaluation
A spine specialist begins with a detailed neurological examination that checks your reflexes, muscle strength, coordination, balance, and sensation. Classic signs of myelopathy include hyperactive reflexes or hand clumsiness. You may also have trouble walking in a straight line or performing fine motor tasks. These findings ultimately help distinguish spinal cord problems from simpler nerve root issues.
Imaging Studies
Magnetic resonance imaging (MRI) is the gold standard for diagnosing cervical myelopathy. MRI shows the area of compression and any signal changes inside the spinal cord, indicating tissue damage. CT scans and X-rays can also be used to assess bone spurs or alignment issues, as well as instability that can contribute to stenosis.
Why Accurate Diagnosis Matters
Precise diagnosis allows surgeons to choose the right treatment approach and estimate potential recovery. It also rules out other conditions, like peripheral neuropathy or multiple sclerosis, that can mimic myelopathy symptoms.
Treatment Options for Cervical Stenosis with Myelopathy
Once myelopathy is present, treatment focuses on preventing further spinal cord damage. Mild cases may be briefly monitored, but most patients with cervical stenosis and myelopathy need surgical decompression to protect spinal cord function and prevent progression.
When Conservative Treatment May Be Considered
Your doctor may consider more conservative options, like activity modification, physical therapy, and anti-inflammatory injections, but usually only in mild or stable cases. Because myelopathy involves actual spinal cord injury, nonsurgical care rarely stops progression once symptoms begin.
Why Surgery Is Often Necessary
Myelopathy is not mere nerve irritation. It can represent spinal cord damage, which can cause lasting issues if left unchecked. Surgical decompression can halt neurological decline and could even lead to improvement in coordination, strength, or balance, especially if performed early.
Surgical Treatment Options
Surgeons choose from several techniques, depending on your anatomy and the location of compression:
- Decompression procedures: A laminectomy removes part of the vertebrae to create space, while laminoplasty reshapes and reopens the spinal canal. Both procedures are performed from the back of the neck and aim to relieve cord pressure and stop progression.
- Fusion procedures: Significant bone removal or instability may require a spinal fusion, typically through an ACDF (anterior cervical discectomy and fusion) that provides long-term stability. The loss of neck mobility depends on the extent of surgery, but for smaller operations, patients rarely notice any difference.
What to Expect from Surgery for Cervical Stenosis with Myelopathy
Knowing what happens before, during, and after surgery can increase your confidence and preparation for treatment. Ideally, your procedure will relieve pressure on the spinal cord and prevent further decline.
Pre-Operative Preparation
Before surgery, your team reviews your medical history and imaging to plan the safest, most effective approach. You’ll likely be asked to stop smoking and manage other chronic health conditions. To ensure optimal readiness, you also need to complete pre-surgical testing.
The Surgical Procedure
The operation is performed under general anesthesia with spinal cord monitoring to help ensure nerve safety. The duration of surgery depends on how much of your spine is involved. Many surgeries can be performed within a couple of hours.
Hospital Stay
Most patients stay overnight in the hospital for monitoring, although it may be possible to go home the same day. You’ll usually be encouraged to walk soon after surgery, often within hours, to help promote circulation and recovery.
Recovery and Rehabilitation
Your surgeon may prescribe a neck brace for support during early healing. Physical therapy and exercises will also help restore your strength and flexibility while improving balance. Most patients typically return to normal activities gradually over several months.
Expected Outcomes
Surgery’s main goal is to stop the progression of myelopathy. Many patients notice improvements in hand function or balance, but existing spinal cord damage may not fully reverse. Early intervention is strongly linked to better outcomes.
Why Early Treatment Matters for Cervical Stenosis with Myelopathy
Cervical myelopathy is a progressive condition, and your symptoms will likely worsen over time if left untreated. Spinal cord nerve cells cannot regenerate once damaged. Prolonged compression can lead to permanent function loss. Early treatment is critical to prevent an irreversible decline.
Studies consistently show that patients who undergo earlier surgical decompression have better recovery, balance, and hand coordination than those who delay. Even surgery can’t fully restore lost function once significant spinal cord injury occurs.
Recognizing When It’s Time for Evaluation
Experiencing persistent hand clumsiness and difficulty with buttons or utensils is a strong indicator of treatable cervical myelopathy. Early diagnosis offers the best chance for meaningful recovery, so don’t chalk these issues up to part of “normal aging.” Seek answers from a spine specialist as soon as possible.
Choosing a Specialist for Cervical Stenosis with Myelopathy
Choosing the right specialist is one of the most important steps toward recovery. The best outcomes come from treatment by a board-certified neurosurgeon with advanced training and extensive experience in spine surgery.
Why Subspecialty Expertise Matters
Myelopathy is a complex spinal cord disorder that demands precise surgical judgment and technical skill. Surgeons who focus their practice on spine subspeciality instead of a broad range of unrelated procedures often have the depth of knowledge and skill necessary for safe, effective treatment.
What to Look for in a Neurosurgeon
When researching surgeons, look for board certifications and fellowship training in spine surgery. A good surgeon will offer proven experience treating cervical myelopathy and take the time to listen and answer your questions to instill confidence in your care plan.
Questions to Ask During Your Consultation
Important answers you’ll need to make an informed decision about your care include:
- How many myelopathy surgeries do you perform each year?
- Which surgical approach do you recommend for my condition, and why?
- What are the risks and consequences of surgery?
- What results should I realistically expect?
- What are the risks of delaying surgery?
The Neurosurgeons of New Jersey Approach
Neurosurgeons of New Jersey provides comprehensive, patient-centered care for individuals with cervical stenosis and myelopathy. Each patient receives an evaluation by a board-certified spine specialist who focuses on identifying the precise cause and severity of spinal cord compression.
From diagnosis through rehabilitation, we communicate clearly and provide evidence-based treatment with compassionate support. Our practice offers the full spectrum of care, from conservative management, routine or complex spinal procedures, to post-surgical rehab under one roof.
With multiple convenient locations across New Jersey and New York and dedicated insurance specialists, patients can focus on recovery while we handle the logistics of care.
Don’t Wait: Early Treatment Protects Your Future
Cervical stenosis with myelopathy is serious but highly treatable, especially when addressed early. Don’t dismiss symptoms as normal aging. They may signal spinal cord compression that requires prompt attention. Early surgical treatment can improve function and prevent progression, helping to preserve your independence and quality of life.
If you’ve experienced these symptoms, contact Neurosurgeons of New Jersey today to schedule a consultation with one of our specialized spine surgeons.
Frequently Asked Questions About Cervical Stenosis with Myelopathy
What is the difference between cervical stenosis and myelopathy?
Cervical stenosis means narrowing of the spinal canal in the neck. Myelopathy occurs when the narrowing compresses and damages the spinal cord, causing neurological symptoms.
What are the early warning signs of cervical myelopathy?
Early symptoms often include hand clumsiness or difficulty with fine motor tasks, numbness or tingling, balance problems, and weakness.
Can cervical stenosis with myelopathy be treated without surgery?
Conservative care may help mild, stable cases, but surgery is usually needed once spinal cord damage is present to prevent further decline.
How serious is cervical stenosis with myelopathy?
It’s a serious neurological condition. Without treatment, it can cause permanent weakness, loss of coordination, or paralysis.
What happens if cervical myelopathy is left untreated?
Untreated myelopathy typically worsens over time, leading to irreversible spinal cord injury and lasting functional loss.
How is cervical stenosis with myelopathy diagnosed?
Diagnosis combines a neurological exam and imaging studies, especially MRI, which shows spinal cord compression and damage.
What is the success rate of surgery for cervical myelopathy?
Most patients experience stabilization or improvement in symptoms, with success rates reported around 80–90% for preventing progression.
Can myelopathy symptoms improve after surgery?
Yes. Many patients regain strength, balance, and coordination, though the degree of recovery depends on how advanced the damage was before surgery.
About Ridgewood
Our team of board certified physicians, located in Ridgewood, New Jersey, are dedicated to bringing you the latest developments and treatment options for spinal surgery. We strive to produce the most clarified & clear content to help you make informed decisions on your medical journey. The road to feeling like your true self should not feel lonely- Let us help you. Please call us to schedule a consultation and speak to one of our team members.
