Posts Tagged ‘numbness in hands, cervical stenosis with myelopathy’
Myelopathy Spine Surgery
Narrowing of spinal canal and compression of the spinal cord due to a herniated disc. Cervical stenosis is the narrowing of the spinal canal in the neck region and can occur from several causes, among them disc herniation and degenerative disc disease, or spondylosis. With advanced stenosis, nerve root and spinal cord compression can occur, with symptoms varying from mild to very serious. One nerve root (monoradiculopathy) or several roots (polyradiculopathy) may be affected. When compression results in damage to the spinal cord, it is termed myelopathy…
Symptoms from cervical spinal stenosis without spinal cord compression are usually limited to neck pain and symptoms from nerve root compression. They include sensory changes of tingling, numbness, and paresthesias in the upper extremity. These symptoms can overlap with those of developing cervical myelopathy (see below) and can include a gradual progression of clumsiness, weakness, or numbness in the hands or fingers.
Dysfunction of the spinal cord is termed myelopathy. The dysfunction can result from many sources including cervical stenosis and herniated discs (see above). Spinal cord injury that is painless suggests a process going on within the spinal cord itself, such as multiple sclerosis, tumor, infection, or vitamin deficiency. Pain is present when the nerves and membrane outside the spinal cord are injured as with disc disease of the spine, arthritis, fractures, or tumors developing outside the spinal cord.
Tests for Diagnosis
Physical examination for cervical stenosis will include a neurological exam and testing of your reflexes as well as a visual examination of your walking (gait). Patients with cervical myelopathy frequently have very strong reflexes (hyperreflexia) and changes in their gait pattern. Your doctor may therefore recommend one or more tests to help him assess your spine and spinal cord. Plain x-rays may be obtained or scanning, either CT or MRI, may be recommended. Less commonly, dye may be injected into the spinal fluid to outline the nerves and spinal cord within the spinal canal, and spinal fluid may be analyzed…
Nonoperative treatment for cervical stenosis includes immobilization, traction, physical therapy (exercises, strength training, massage, mobilization) and physical modalities (ultrasound, electrical stimulation, heat), medications (analgesics, NSAIDs, muscle relaxants, corticosteroids). If symptomatic improvement is not achieved with an aggressive nonoperative treatment program within 6 to 8 weeks, patients are reevaluated and surgical treatment may be considered….
The natural history of cervical stenosis and cervical myelopathy is that of a progressive disease which eventually may lead to severe disabilities if left untreated. Some people have extended periods of relative stability where progression slows or is not apparent. With surgical decompression of the spinal cord, significant improvement in sensation and function can occur, most particularly in the upper extremities. The main goals of surgery, however, are preservation of remaining function and relief of pain….
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