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Cervical Spondylotic Myelopathy

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Cervical Spondylotic Myelopathy

  • Dr. Charla Fischer
  • Mar 14, 2020

Our bodies face wear and tear as we age, and our spine doesn’t escape this risk. The cervical spine, which involves the vertebrae on the spinal cord in the neck region, may become compressed due to changes in the spine as we age. This condition is called cervical spondylotic myelopathy, or CSM. Occurring mostly in patients over age 50, CSM can cause a variety of uncomfortable symptoms that may benefit from the help of qualified physicians like Dr. Fischer at NYC Langone in New York City.

What is this condition?
The spine consists of 24 vertebrae, which are the bones stacked upon one another that form the spine. The top seven vertebrae in the neck make up the cervical spine. Along with the vertebrae, the spinal cord has many nerves branching out from it to the rest of the body. There are also disks between each vertebrae that serve as shock absorbers between the bones as movement occurs. When any part of this elaborate system in the spine is damaged or worn, pain and debilitation may result. CSM is one such condition in the cervical spine.

What causes it?
CSM may be caused by a number of degenerative changes to the spine that can happen with age. The most common names for disk degeneration are arthritis or spondylosis. Some reasons that Dr. Fischer sees CSM occur in patients include:

  • Herniated disk – each disk has a jelly-like center, which can press into or squeeze out of the disk when it is damaged. This herniated disk can bulge out and push into the spinal cord or nerves. Aging increases the risk for herniated disks, often occurring during movements like lifting, twisting, or bending.
  • Bone spurs – disks can lose height and bulge with age, as well as dry out and stiffen. When disks lose height and vertebrae get closer together, the body may develop extra bone on its own around the disks. These are called bone spurs, which cause the spine to become stiff and narrow and therefore compress the spinal cord.
  • Rheumatoid arthritis – the autoimmune disease rheumatoid arthritis causes the body to attack itself. Sometimes it attacks the membrane lining the body’s joints, resulting in inflammation, stiffness, and pain. It may also damage the cervical spine joints so that the vertebrae slip and compress the spinal cord.
  • Trauma – a neck injury from trauma like a car accident, sports, or a fall can lead to CFM.

What does it feel like?
Since the spinal cord has many nerves linked to it that reach all over the body, symptoms of CFM are far-reaching. These may include:

  • Weakness in arms, shoulders, or hands
  • Numbness or tingling in arms, hands, or fingers
  • Neck pain or stiffness
  • Loss of balance or coordination
  • Loss of fine motor skills

Symptoms usually have a slow onset and worsen steadily over a few years. However, some patients have experienced rapid declines in their health with CFM.

How do I know if I have it?
When you schedule a consultation with Dr. Fischer, you’ll have a thorough physical examination of your neck, shoulders, legs, arms, and hands. Your reflexes, balance, sensations, walking and more will be assessed. A complete medical history will also be taken and symptoms will be discussed. Diagnostic tests such as X-rays, MRI scans, CT scans, or myelograms may be recommended for complete diagnosis.

How is it treated?
Initial treatment for CSM will likely be nonsurgical in an effort to reduce pain and restore normal body function. Some nonsurgical methods are medications such as anti-inflammatories, corticosteroids, epidural steroid injections, or narcotics in severe cases. Another option is wearing a soft cervical collar to rest neck muscles and restrict movement. Physical therapy to increase flexibility, strengthen muscles and relieve pain may be recommended. In severe cases of CSM, surgery may be the best course of action. The goal of surgery is to reduce pressure on the spinal cord and help you return to normal activities without pain or impairment. If you have worrisome symptoms, see Dr. Fischer for an examination and treatment.


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