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Cervical Myelopathy

Cervical Spondylotic Myelopathy/ Cervical Canal Stenosis/ Cervical Myelopathy due to Ossified Posterior Longitudinal Ligament `{`OPLL`}`

Overview: Cervical Spondylotic Myelopathy is defined as compression of spinal cord due to age related changes in the vertebral column. It may cause symptoms like imbalance while walking, hand dysfunction and weakness in arms/ legs. This is a slowly progressive disorder. In most cases, surgery is recommended to relieve the compression.

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Cervical- Neck, Spondylotic– Age related degeneration, Myelopathy– Compression of Spinal Cord, Cervical – Neck, Canal– Passage through which the spinal cord passes, Stenosis– Narrowing, Ossified Posterior Longitudinal Ligament– There is a ligament [soft tissue joining two bones] found in spine which may ossify become bone like- harden and cause compression on spinal cord giving rise to myelopathy.

Myelopathy is defined as any compression on spinal cord. It gives rise to a symptom complex which usually occurs due age related degeneration or spondylosis causing narrowing of the passage through which the spinal cord passes. Sometimes, ligaments joining bones may ossify and cause compression [OPLL]. It is a disease of elderly. This compression usually gives rise to symptoms like imbalance while walking and fine motor dysfunction like change in handwriting, difficulty in buttoning of shirts, etc. The process is usually gradual and progressive until it affects activities of daily living.

In some patients, it may give rise to weakness of upper/lower limbs. Subtle signs of myelopathy would be elicited by your surgeon. This pathology and magnitude of compression is assessed on MRI. In most situations of established myelopathy surgery is advised. Since this is usually a progressive condition and most of the times irreversible- surgery is beneficial to prevent further worsening. Based on numerous factors surgery is done from front of the neck [anterior] or from back [posterior]. The aim of surgery is to decompress the spinal cord.

If done from front- Anterior Cervical Discectomy/ Corpectomy and Fusion [ACDF/ACCF] and from behind- Posterior Cervical Laminectomy/ Laminoplasty with or without stabilization is advised.