Cervical Myelopathy Causes and Treatment

What is Cervical Myelopathy?

Cervical myelopathy is a degenerative condition that is characterised by numbness and clumsiness of the hands as well as gait instability. This is caused by spinal cord compression in the neck. The compression can be due to the presence of bone spurs or intervertebral disc herniation.

Patients affected by this condition tend to be in their 60s and above. The severity of cervical myelopathy progresses with time and surgery is usually the treatment of choice in most cases.

Request a Consult

If numbness of your hands is affecting your day-to-day life I can help. Click the button below or call 62652388 to arrange a detailed assessment.

Ask Dr. Ling

Main Causes of Cervical Myelopathy

To understand the main causes of cervical myelopathy it is important to know the structure of the cervical spine.

The cervical spine has 7 stacked bones called vertebrae, labeled C1 through C7. The top of the cervical spine connects to the skull, and the bottom connects to the upper back at about shoulder level. As viewed from the side, the cervical spine forms a lordotic curve that gently curves toward the front of the body and then back.

Cervical myelopathy can be caused by various factors leading to pressure on the spinal cord in the neck:

Disc degeneration
Injury or repetitive strain
Herniated discs
Spinal stenosis & bone spurs

Disc Degeneration

As we age, spinal discs lose water content, becoming less flexible, more brittle and thinner. This makes them more susceptible to tearing or bulging even with minor strain or twisting.

This natural degeneration starts relatively early in life (often in the 30’s) but progresses over time.

Injury & Repetitive Strain

Sudden force: A fall, blow to the neck, violent twisting motion, or rear-end car accidents resulting in whiplash.

Repetitive Strain and Poor Posture: Prolonged poor posture, such as hunching over a computer or phone, can strain neck muscles and contribute to pain.

Herniated Discs

When a disc’s interior pushes out, it can press on the spinal cord in the cervical area.

Spinal Stenosis & Bone Spurs

Bone spurs or thickened ligaments narrow the spinal canal, compressing the spinal cord.

Diagnosing Cervical Myelopathy

A patient is suspected to be suffering from Cervical Myelopathy when he/she presents with the above-mentioned symptoms. To confirm it, an MRI scan of the lower back must be performed.

Physical Examination:

Your doctor will assess your posture, movement, and strength to evaluate how your spine and muscles are functioning.

X-ray:

An X-ray helps detect signs of fractures, degenerative changes, or issues in the bones of the spine.

MRI (Magnetic Resonance Imaging):

An MRI provides detailed images of soft tissues like discs, muscles, and nerves, helping identify conditions such as herniated discs or nerve compression.

CT Scan (Computed Tomography):

A CT scan allows us to visualize the bones more clearly.

Treatment Options

Patients can be treated conservatively when their symptoms are mild initially. Conservative treatment can be in the form of physiotherapy to strengthen the neck muscles as well as painkillers to alleviate the symptoms. As the condition worsens with time and walking independently becomes a problem, surgery is usually the treatment of choice.

Depending on the nature of spinal cord compression and severity of the condition, the surgery can be performed either from the front (Figure A) or the back of the neck (Figure B). The goals of the surgery are to decompress the spinal cord and to provide stability to the cervical spine.

General Pain Treatment For Your Back

There are a variety of pain treatment options available, ranging from non-surgical methods to surgery, depending on the severity of your condition.

Non-surgical Treatment

Physical therapy: A tailored physical therapy program can help you strengthen muscles, improve posture, and increase flexibility, all of which contribute to a stronger, healthier back.
Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants can reduce inflammation and ease pain.
Steroid injections: For severe pain, corticosteroid injections can provide temporary relief by reducing inflammation around the affected area.
Radiofrequency ablation injections: Radiofrequency ablation uses radiofrequency energy to disable the sensory nerves in the joints that cause pain. Deactivating the pain-causing nerves brings about long-lasting relief from chronic backache.

Surgical Treatment

In some cases, surgery may be necessary if other treatments have not provided sufficient relief or if you are suffering from conditions such as a herniated disc, spinal stenosis, or severe nerve compression. Surgical options might include:

Spinal Decompression: This procedure involves removing part of a herniated disc (microdiscectomy) or part of a lamina (laminotomy) to relieve pressure on the spinal cord or nerves, which can help alleviate pain and improve function.
Spinal fusion: Fusing two or more vertebrae together to stabilize the spine.

Insurance Partners

We work closely with trusted insurance partners to make your treatment seamless. Contact us, and we’ll guide you through the process at every step of the way.

Back Pain Specialist in Singapore

Dr. Marcus Ling is a Senior Consultant Orthopaedic Surgeon with a special focus on minimally invasive and motion-preserving spinal surgery. A dedicated clinician and educator, he has led advancements in spinal care while mentoring future surgeons. Known for his compassionate approach, he prioritises patient well-being, ensuring expert, personalised treatment for every individual. Dr. Ling is also one of the few surgeons that can perform awake spinal fusion without the need for general anaesthesia. This approach minimises downtime, allowing patients to be discharged within 24 hours of surgery when possible.

Why Choose Dr. Marcus Ling?

Minimally Invasive Treatments
Dr. Marcus Ling is trained and specialises in keyhole techniques that encourage quicker recovery, reduce pain, and lessen disruption to your life.
Caring Approach
Dr. Marcus Ling listens to your concerns and takes the time to explain all your treatment options, ensuring you feel informed and supported every step of the way.
Insurance Assistance
We guide you through the insurance process, making sure you have the support you need for a smooth and stress-free experience.

    
 
 
       Posted on Google  
   
   Amy Poh Sim Tay 
 
 
 
 Trustindex verifies that the original source of the review is Google. From my very first consultation to the post-operation follow-up, the experience has been outstanding and excellent. Dr Marcus Ling is a top notch surgeon who provided a clear and comprehensive explanation of my condition and the procedure, so I was fully informed and reassured at every step. He is exceptionally caring and thoughtful about his patients’ well being throughout and that genuine concern is truly commendable. I am also grateful  to his nurses, who were supportive, efficient, most polite and professional.
  
 
      Posted on Google  
   
   Margaret Ng 
 
 
 
 Trustindex verifies that the original source of the review is Google. I first saw Dr Marcus Ling for sciatic nerve pain on my left leg. It was impacting my daily life as I could not sit or walk for long without feeling pain in my left leg. Dr Marcus first went through my MRI and X-ray scans to determine the cause of the pain. After confirming that it was due to a compressed nerve, he went through the various treatment options with me. He was clear in explaining the pros and cons of each option, as well as the risks involved. I opted for radiofrequency ablation procedure. I recovered well after the procedure and 1 week post procedure, the pain is largely gone. I am very thankful to Dr Marcus for his care throughout the process. It is such a relief to be pain-free again, and I would definitely recommend him to anyone experiencing similar issues.
  
 
      Posted on Google  
   
   Autumn (*) 
 
 
 
 Trustindex verifies that the original source of the review is Google. Dr Marcus Ling is very caring and attentive towards his patient. He always has a warm smile. He will suggest different treatment options to the patient. He explains every treatment process clearly to the patient before deciding which option to choose. I am grateful to Dr Marcus Ling for his professional skills and help me regain my health. Thank you, Dr Marcus Ling 😊
  
 
      Posted on Google  
   
   Woon WeeKoon 
 
 
 
 Trustindex verifies that the original source of the review is Google. Extremely grateful to Dr. Marcus Ling for the excellent care he provided throughout my spine surgery journey. I underwent L4/L5 decompression, instrumentation and fusion, and from the first consultation to my post-operative follow-ups, Dr. Ling was professional, patient, and reassuring. He took the time to explain my MRI findings, the surgical options, the risks and benefits, and answered all of my questions thoroughly, which gave me confidence in proceeding with the operation. The surgery was successful, and my recovery has been progressing well. Throughout my follow-up visits, Dr. Ling has been attentive, caring, and meticulous in monitoring my healing. He never made me feel rushed and always listened carefully to my concerns, offering practical advice and reassurance. I would highly recommend him to anyone seeking a skilled and caring spine surgeon.
  
 
      Posted on Google  
   
   wanying chan 
 
 
 
 Trustindex verifies that the original source of the review is Google. Had my cervical spine disc replacement surgery with Dr. Marcus Ling. Very confident doctor with Impressive surgical skills. Surgery is spot on with an impressive team ( seen them very briefly in OT just before I got knocked off but  can really feel their synergy) and recovery is rather fast too. 2 weeks post surgery, feeling great. Long way to go but I already look forward to my next long distance hut to hut trek. ☺️ Thanks doctor and his team, nurses and admin included, for the job well done. Highly recommended.
  
 
      Posted on Google  
   
   ChoonChuen Seet 
 
 
 
 Trustindex verifies that the original source of the review is Google. Dr Marcus is thorough and caring. I have a successful surgery on the rotator cuff repair with him. Thank you.
  
 
      Posted on Google  
   
   Yet yen Yan 
 
 
 
 Trustindex verifies that the original source of the review is Google. Dr Marcus Ling was consulted on low back pain. It was evident that he tries his best to bring value to his patients and recommends the most appropriate treatment under his skillful hands
  
 
      Posted on Google  
   
   Ivan Bien 
 
 
 
 Trustindex verifies that the original source of the review is Google. I had a good and positive experience with Dr. Marcus Ling for my treatment. I was diagnosed with a slipped disc and had to undergo a microdisectomy. He explained the surgery required and provided the necessary information for me to make the decision. I'm grateful that the surgery was successful and relieved of the sciatica pain.