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You may have a spinal cord injury in your neck. Arthritis (or disc
problems) in the neck can cause damage to just one nerve or to the entire
spinal cord. When one nerve is pinched, there may be numbness in one part
of the arm or weakness in one muscle. When the spinal cord is pinched, a
“myelopathy” can develop. The arms may hurt because of
pinched nerves. The
legs will become stiff due to pressure on the spinal cord itself. Loss of
coordination is also common.
Myelopathy can come on slowly or be the result of an injury. A history
of a fall with the neck extended is common. An MRI of the neck ordinarily
shows the problem. The MRI will show a smaller than normal spinal canal.
It can show a spinal cord bruise. X-rays, an EMG, and other studies are
sometimes needed.
When there is a myelopathy, surgery is usually required. The operation
may be done from either the front, from the back, or using a combination.
The posterior (back) surgery is more painful but does not require a
fusion. It is used when many levels are abnormal. The anterior surgery
uses
minimally invasive and bloodless techniques. It is less painful and
requires less time in the hospital. Although it does involve fusion, it is
not necessary to use your own hip for bone. The hip graft is painful and
there are now good alternatives to your own bone.
Although the prospect of neck surgery can be terrifying, the results of
the operation are good in over ninety percent of patients. One should pick
the least invasive surgery and avoid the use of a hip graft if possible. |
