Cervical Spondylotic Myelopathy (CSM)

What is cervical spondylotic myelopathy (CSM)?

Your spinal cord is a group of nerves that runs from your head to your lower back. The cervical spine is the part in your neck. Cervical spondylotic myelopathy (CSM) is a compression of the spinal cord in your neck. A compression of the spinal cord means pressure, pinching, or squeezing on it.

CSM often affects adults 40 years or older. It can affect younger people born with narrow spinal canals and men at an earlier age than women.

Symptoms of cervical spondylotic myelopathy

Symptoms of CSM are wide-ranging and occur over time. They can include:

• Neck pain or stiffness
• Arm pain
• Numbness in your hands or weakness of your arms and legs
• Trouble using your hands or walking
• Loss of bladder or bowel control

What causes cervical spondylotic myelopathy?

Changes in the bones, discs, and ligaments of your spine as you age can cause pressure on the spinal cord. Sometimes growths called bone spurs add pressure to the spine. These changes often occur due to normal aging. Rheumatoid arthritis can also cause CSM as well as spinal cord trauma.

How is cervical spondylotic myelopathy diagnosed?

Your doctor will do a physical exam and review your symptoms. They will look for changes in your feeling, strength, and reflexes. Your doctor also will do a magnetic resonance imaging (MRI) test. This uses radio waves to take pictures of your spine. The test can confirm if you have spinal cord compression in your neck. It also can show other problems that have similar symptoms to CSM. Your doctor may have to do other tests to confirm the cause of CSM. One of these tests may be a CT scan. They also may refer you to an orthopedist or neurosurgeon.

Can cervical spondylotic myelopathy be prevented or avoided?

You cannot fully prevent cervical spondylotic myelopathy (CSM) because it is most often caused by age-related changes in the spine. However, certain lifestyle choices may help lower your risk or slow progression. These include staying physically active, practicing good posture, avoiding tobacco, and protecting your neck from injuries. Early diagnosis and treatment of neck problems may also help prevent severe complications.

Cervical spondylotic myelopathy treatment

Treatment depends on how severe your symptoms are and how much pressure is on your spinal cord.

• Mild cases: If your symptoms are not severe, your doctor may recommend regular checkups and nonsurgical care. This could include physical therapy to improve strength and balance, medicines to reduce pain or stiffness, and lifestyle changes to protect your neck.
  
• Moderate to severe cases: If your symptoms are getting worse or you have significant spinal cord compression, surgery may be recommended. Surgery can relieve pressure on the spinal cord and prevent permanent nerve damage. Common procedures include removing bone spurs or disks that press on the spinal cord, or stabilizing the spine with plates, screws, or rods.
  

Your doctor will talk with you about the risks and benefits of surgery versus nonsurgical options, based on your age, overall health, and the severity of your condition.

Living with cervical spondylotic myelopathy

Cervical spondylotic myelopathy (CSM) can slowly get worse if it is not treated. Some people may have mild symptoms that stay stable, while others notice increasing weakness, pain, or problems with balance. Working closely with your doctor is important to track changes and adjust your care plan.

Treatment such as physical therapy, medicines, or surgery can help manage symptoms and protect your spinal cord from further damage. Lifestyle changes—like staying active, using good posture, and avoiding neck strain—may also make daily activities easier.

Support from family, physical therapists, or support groups can help you cope with the impact of CSM on your quality of life.