Diagnosing cervical spinal stenosis and myelopathy
As part of your thorough history and physical exam, we use the Modified Japanese Orthopaedic Association scale—an international standard—to assess the severity of your spinal cord damage. The scale measures extremity numbness, weakness and coordination problems; bladder and bowel problems; fine motor skills of the hands; and balance issues.
We routinely use magnetic resonance imaging (MRI) of the cervical spine to give us high-resolution pictures of the spinal cord and surrounding tissues.
Treating cervical spinal stenosis and myelopathy
Ohio State offers treatments ranging from physical therapy to the most complex neck and spine surgeries. Our physicians, therapists and other caregivers provide you with options that increase mobility and reduce pain. Most people who come to Ohio State Spine Care don’t require surgery.
One of Ohio State’s strengths is our physical therapy program, with therapists who specialize in complex, degenerative spine conditions. Following a thorough examination of posture, neck mobility, strength and flexibility, our physical therapists customize a plan for you. We take into account any impairments or functional limitations you have. Typically, you’ll work one-on-one with a therapist on pain-relieving movement strategies and on improvements in balance, strength and flexibility.
Additional nonsurgical treatments include:
- Anti-inflammatory medications and neuropathic (nerve injury) pain medications for symptoms of burning, tingling and numbness
- Education on neck care and recommendations for specific needs (such as job demands, recreational activities, home setup)
- Real-time ultrasound imaging (RUSI) of movement in the spine area to retrain the deep stabilizing musculature of your spine (a highly researched, evidence-based intervention)
- Training to restore balance and prevent falls
- Weight loss guidance, emphasizing healthier eating and exercise to ease pressure on the spine
- Pilates, yoga and aquatic therapy to strengthen back muscles
Acupuncture (provided at Ohio State Spine Care) or dry needling for pain control through Ohio State’s Center for Integrative Medicine.
You may need surgery if you have moderate to severe cervical spinal stenosis with myelopathy. Surgery can prevent further spinal cord damage and perhaps allow the spinal cord to recover over time, with the aid of physical therapy.
We may conduct additional studies as we evaluate you for surgery:
- Electromyography (EMG), which can detect muscle weakness due to nerve problems
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI)
Ohio State’s spine specialists perform more than 500 complex spine surgeries a year, more than anywhere in central Ohio. We use the least invasive surgery possible to protect your spinal cord from progressive damage:
- Decompression surgery, which can be performed from the front or back of the neck
- Laminectomy is performed from back of the neck, removes part of the vertebra (neck bone) and relieves pressure on your spinal cord. Our surgeon may use metallic plates and screws to prevent slippage of one vertebra over another.
- Spinal cord decompression from the front is performed by removing bone and a disc or discs and fusing vertebrae.
- Spinal fusion surgery is sometimes used in the laminectomy procedure to fuse vertebrae and restore stability to the spinal column; for cord decompression from the front, spinal fusion and using metallic plates and screws are always part of the procedure.