People who have a disorder of the neck known as cervical spondylotic myelopathy (CSM ) develop cervical compression as a result of aging-related changes to the spine's wear and tear. While patients over 40 are more likely to experience the illness, younger individuals who were born with narrower spinal canals may also experience it.
The spine consists of 24 vertebrae, including the cervical spine, which forms the neck. Cervical compression occurs in the cervical spine, which is made up of seven small vertebrae. The spinal cord and nerves extend from the skull to the lower back and travel through the central canal. Intervertebral disks, flat and round, act as shock absorbers between vertebrae. Cervical compression patients experience a wide range of symptoms, often vague, due to spinal cord compression. These symptoms can cause weakness, numbness, balance loss, dexterity loss, and neck pain.
Degenerative changes in the spine that come with aging are the cause of cervical compression. These degenerative disk changes are commonly referred to as spondylosis or arthritis.
Bone Spur: The disks in the spine start to bulge and lose height as they get older. They also start to dry up, lose water content, and stiffen. The disk spaces settle or collapse as a result of this issue, and the height of the disk spaces decreases.
The vertebrae get closer together as the disks get thinner. In response to the disk collapsing, the body strengthens the disk by growing more bone spurs surrounding it. The spine becomes more rigid as a result of these bone spurs.
Additionally, they could compress the spinal canal, crushing or pinching the spinal cord.
Herniated disk: When the jelly-like interior of a disk(nucleus pulposus,), presses against the outer ring(annulus fibrosus), the disk herniates. The nucleus may completely squeeze through if the disk is severely damaged or worn out. A herniated disk may push on the spinal cord or nerve roots when it protrudes toward the spinal canal.
Age-related disk deterioration increases the likelihood of disk herniation. Herniated disks frequently happen when someone lifts, pulls, bends, or twists.
Other Myelopathy Causes: Other disorders that cause cervical compression can also result in myelopathy. These conditions may cause similar symptoms to CSM, although having nothing to do with disk degeneration.
Rheumatoid arthritis: It is an autoimmune condition. In other words, the immune system attacks its cells. In this condition, the thin membrane lining the joints, the synovium, is attacked by immune cells.
The swelling of the synovium can cause pain and stiffness, and, in extreme cases, it can cause the destruction of facet joints in the cervical spine. The amount of room available for the spinal cord is decreased when this happens.
Injury: Myelopathy can also result from a neck injury caused by sports, car accidents, or falls.
For example, hyperflexion—a forward motion of the neck beyond normal limits—or hyperextension—a backward motion of the neck beyond normal limits—may occur in a rear-end auto crash. Cervical compression may result from these injuries because they commonly damage the ligaments and muscles that support the vertebrae.
The signs and symptoms of cervical compression usually appear gradually over a few years. However, the illness may progress more quickly in some patients. Cervical compression will inevitably worsen over time, regardless of pace.
Individuals who have cervical compression may have some or all of the following symptoms:
After discussing your medical history and general health, your doctor will ask you about your symptoms. They will conduct a thorough examination of your neck, shoulders, arms, hands, and legs, looking for:
X-rays provide images of dense structures like bone, while MRI scans show soft tissues and spinal cord compression. CT scans show narrowing of the spinal canal and can determine if bone spurs have developed in the cervical spine. A myelogram is a special type of CT scan that injects contrast dye into the spinal column to make the spinal cord and nerve roots more visible. These imaging methods help diagnose and treat neck pain.
Cervical compression may initially be treated nonsurgically in milder situations. Reducing discomfort and enhancing the patient's capacity to carry out everyday tasks are the objectives of nonsurgical treatment. In other words, nonsurgical treatment does not address the underlying problem; it just does not make more room in the spinal canal for the spinal cord.
Nonsurgical treatment options include:
Soft cervical collar: This padded ring goes around the neck and is secured with velcro. To minimize neck motion and give your neck muscles a chance to rest, your doctor could suggest that you wear a soft cervical collar. Wearing a soft collar for extended periods can weaken your neck's muscles, so you should only wear it for a short duration.
Physiotherapy: Certain exercises can improve flexibility, strengthen the neck muscles, and reduce pain. You can carry out your everyday tasks more easily if you have strength and endurance thanks to physical therapy. Traction can occasionally be used to gently extend the neck's muscles and joints.
Medications: In some cases, medications can help improve your symptoms.
Nonsteroidal anti-inflammatory drugs (NSAIDs): Anti-inflammatory drugs like aspirin, ibuprofen, and naproxen can help relieve pain and reduce inflammation.
Oral corticosteroids: A short course of oral corticosteroids may help relieve pain by reducing inflammation.
When non-surgical alternatives are insufficient to relieve pain or in situations where there is significant compression, surgery is usually reserved as a last resort. Various surgical techniques exist based on a particular cause:
Discectomy: This involves removing the compressed spinal cord caused by a herniated disc.
Laminectomy: To make greater room for the spinal cord, a section of the bony vertebrae is removed.
Spinal fusion: To give stability and prevent more compression, this process joins the vertebrae together.
Cervical compression can be a worrying and disturbing condition. On the other hand, being aware of the signs, causes, and available treatments gives you the ability to make informed decisions about your health. You can get a lot of relief by looking into non-surgical methods like physical therapy and pain management. Never forget that early diagnosis can prevent further complications. Recent advances provide both surgical and non-surgical treatment options for your betterment.