Cervical
Procedures in San Francisco CA

Cervical Myelopathy

“Snake Eyes” Appearance of Myelomalacia on MRI

In the lumbar spine, the nerves to the lower extremities, bowel, and bladder pass through the spinal canal in a new sac filled with spinal fluid. In the neck, instead of the group of nerves passing through, the spinal cord makes its way from the brain all the way down to the L1-2 lumbar level, where it stops, continuing on as individual nerves below that point. As in the lumbar spine, individual nerves leave at each joint in the neck, in this case to go to the arms or upper trunk area.

When an abnormal condition causes too much pressure on the spinal cord, the spinal cord’s ability to transmit signals becomes compromised, and certain physical findings and disability occur. When complete loss of function occurs, paralysis of the upper and lower extremities results, depending on the level of the compression. When the spinal cord is not functioning properly due to disease processes such as compression or degeneration, cervical myelopathy develops. The initial signs of cervical myelopathy include abnormal reflexes, poor balance, numbness in the upper extremities, electrical sensations in certain neck positions usually radiating down the body or arms, and increased urinary frequency.

Increasing severity can result in partial or complete paralysis of the extremities and loss of sensation below the site of the compression. Because the spinal cord does not heal as well as individual nerves after they have passed through the spinal cord, timely correction of cervical myelopathy can be more crucial when the spinal cord compression is surgically correctable. Because of this, when we as spinal surgeons see signs of decompensation in spinal cord function, we will arrange to repair the problem as quickly as reasonable. Delays to correct cervical myelopathy can result in permanent weakness or paralysis of upper and/or lower limbs.

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