Dr. Pranjal Pandey
Cervical Spondylotic Myelopathy Treatment Delhi
MBBS, MS (General Surgery), M.Ch. Neurosurgery. A neurosurgeon with over 10 Yrs. years of experience Awarded as the best resident in Neurosurgery and was a regional & zonal winner at TYSA neurosurgery.
CERVICAL SPONDYLOTIC MYELOPATHY (C.S.M.)
Brain and spinal cord are like a main transformer or fuse box from which different wires run towards different rooms of your house. In human body, the spinal cord gives away nerve roots to different areas of the body in a similar fashion. Once the main transformer or fuse box gets damaged due to compression, the entire supply of electricity to the house becomes haywire.
Cervical means Neck, spondylotic means degeneration due to wear and tear and myelopathy means damage to the spinal cord itself.
Information in the form of impulses is conducted from the spinal cord to the body. The cord acts as an information superhighway. When this highway gets narrowed, then information cannot flow freely resulting in classical symptoms of cervical spondylotic myelopathy.
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CAUSES OF CERVICAL SPONDYLOTIC MYELOPATHY
Surgically significant causes of cervical spondylotic myelopathy are usually compressive in nature. A soft and highly sensitive structure like a human spinal cord may be compared to a banana. If the banana is pinched lightly for long duration, it leaves a bruise. Spinal cord gets damaged in a similar way.
- Growth of bony spurs within the spinal canal where spinal cord resides.
- Intervertebral discs may have bulges that may sag into the spinal canal compromising the space.
- The “tape” holding the spinal cord, i.e. “ligaments” may get stiff and bulky compressing the cord.
SYMPTOMS OF CERVICAL SPONDYLOTIC MYELOPATHY
- Clumsy hands is a frequent symptom that is reported. Handwriting starts getting affected (in case of dominant hand) and signatures and cheques might be dishonored. Difficulty in fine motor movements of hands like buttoning unbuttoning shirt may become slower or troublesome.
- Walking becomes difficult. People often remark as if patient is walking in a drunken state. Brisk walk or short run to catch the last bus or metro becomes difficult.
- Advanced stages may see you losing control of your bladder and bowel continence.
- Critical point is NOT to rely on PAIN as a marker of severity. Many patients of severe cord compression may not complain of significant pain.
HOW CAN A NEUROSURGEON HELP IN CERVICAL SPONDYLOTIC MYELOPATHY
The role of a neurosurgeon is primarily to “stop the clock”. If the disease is caught early, then performing a surgical correction prevents further damage and may cause functional recovery. However, late presentation or ignoring the symptoms may lead to progressive paralysis, bed or wheelchair bound life and may result in, potentially, death.
To prevent such deterioration, a neurosurgeon may operate and decompress the spine along with its fusion to provide stability.
Bottom line is cervical spondylotic myelopathy is generally a slowly progressive disease. It is a quiet condition with very loud clinical effects and needs to be addressed urgently.