Legendary Care

Dr Frey
Dr. Frey
Dr Schmidt
Dr. Schmidt
Contact Us for Appointment


Making an Appointment
Phone, Forms, Directions


colorado spine logo
Telephone: (303) 762-0808
Fax: (303) 762-9292
colorado spine logo
Telephone: (303) 762-0808
Fax: (303) 762-9292
Contact Us for Appointment


Making an Appointment
Phone, Forms, Directions

Denver Spine Surgery Office


2535 S Downing Street
Denver CO 80210

Practice News


Dr. Frey's 15 Hour Marathon surgery is a game changer for top Sled Hockey player.

green slash

Explaining Spinal Disorders: Cervical Myelopathy


Cervical myelopathy refers to a constellation of symptoms and signs due to spinal cord compression in the neck.  Because symptoms and signs in a patient with myelopathy can be subtle in early manifestations, the diagnosis may easily be missed or incorrectly attributed to “normal” aging process.  However, because the natural history of cervical myelopathy is one of stepwise progression, early recognition and treatment is essential for optimal patient outcome before the onset of irreversible spinal cord damage.


Patients present with a variety of symptoms.  There may be a generalized feeling of clumsiness of the arms and hands (such as tendency to drop objects), difficulty to work with small objects such as buttons or coins, changes in handwriting, and generalized numbness.  Worse prognostic symptoms include instability in walking, increased tripping or imbalance during walking.  Family members may comment that the patient walks as if drunk.  Patients with severe spinal cord compression may report electric shock-like sensations down the spine or arms when the neck moves in a certain manner.

In the later stages of the disease, the patients may experience a sense of overall weakness of their arms and legs, as well as changes in their bowel and bladder habits.  Despite advanced myelopathy, many patients do not experience any neck pain at all, and this may be one reason that the condition of myelopathy is not diagnosed until very late.

  • Early signs: Hand clumsiness and handwriting deterioration
  • Late signs: Walking imbalance


The process of cervical myelopathy is due to compression of the spinal cord in the spinal canal.  The physical act of compression, or stenosis, may be a result of different conditions.  The most common cause is due to degenerative changes of the cervical spine, known as cervical spondylotic myelopathy.  As the cervical spine degenerates, disc herniations or bulges along with arthritic bone spurs can all cause narrowing of the spinal canal, which in turn results in the compression of the spinal cord.  Patients who are born with smaller spinal canal diameter (congenital spinal stenosis) have a higher propensity to compress the spinal cord when degeneration occurs.  Another condition that results in compression of the cord is known as ossification of the posterior longitudinal ligament (OPLL).  In this condition, the ligament in the spinal canal overgrows with abnormal bone, and this in turn causes compression of the spinal cord.


Abnormal reflexes or subtle changes in a patient’s strength when tested by a medical provider, may prompt them to order further imaging studies to help with diagnosis.  X-rays can help delineate whether there is congenital narrowing of the spinal canal, as well as bone spur formations due to degeneration, which may be pressing on the spinal cord.  Advanced studies, such as MRI or CT scans with dye, are the tools of choice in confirming spinal cord compression.

Nonoperative Management

Unfortunately, symptomatic myelopathy is a progressive disease resulting in irreversible damage of the spinal cord, and is thus considered a surgical disorder.  As we understand more about the pathology of cervical myelopathy, it is now regarded as a surgically condition.

Surgical Treatments

In studies of patients with cervical myelopathy, surgical treatment has been shown to improve functional outcomes, the amount of pain, and neurologic status.  It has also been demonstrated that early intervention improves the prognosis by helping to prevent permanent destructive changes of the spinal cord.  Surgery is the treatment of choice unless the patient is unwilling or unable to undergo surgery.  The goal of surgical treatment for cervical myelopathy revolves around relieving the pressure and compression off of the spinal cord.  Depending on the specific mechanism of compression, different methods of surgical treatment may be used to achieve the goal of spinal cord decompression.


Cervical myelopathy is a disorder that is typically treated surgically.  Early treatment before the onset of permanent spinal cord injury is recommended.  The surgical procedure chosen must be tailored to the patient’s specific pattern of stenosis, comorbidities, and symptoms.


Spivak J, Connolly P. Orthopaedic Knowledge Update: Spine 3. American Academy of Orthopaedic Surgeons, Rosemont, IL. 2006.
American Family Physician. 2001 May 15;63 (10):1916.


MRI of the neck showing multilevel compression of the spinal cord.

MRI cervical myelopathy
MRI cervical myelopathy 2

By using this site, you acknowledge that you have read and agreed to the terms of our User Agreement . The information provided is not intended to replace the medical advice of your doctor or health care provider.
© 2004-2022 Colorado Comprehensive Spine Institute

LastUpdate: 2016-12-20 22:19:35

  • top