Visit if you have any questions about
Spinal Stenosis or Cervical Myelopathy.
Spinal stenosis is a medical term that describes narrowing of the
space available for the spinal cord and nerve roots in the spinal
Cervical myelopathy is degenerative spinal disease that is a common
cause of neck pain, clumsiness, difficulty walking, and problems with
coordination and balance.
Spinal stenosis causes a narrowing of the the canal, and if the
pressure is severe enough, cervical myelopathy with occur.
These two conditions most commonly affect people after the age of 60,
but sometimes we see these conditions in younger patients who have
large cervical disk herniations or very small spinal canals.
The most common reason that someone develops cervical myelopathy is
because the natural aging process that causes arthritis of the spine
narrows the spinal canal and squeezes the spinal cord.
If this pressure is present for several months or so, the spinal cord
will show signs of deterioration and bruising on the MRI scan of the
The radiologists describe this finding as T2 signal change, because
the damage to the spinal cord shows up as a bright white signal in the
center of the spinal cord on a particular part of the MRI called the
T2 weighted image.
Lets look at a couple of MRI images of the cervical spine
This first image is a normal MRI scan of the neck.
In this image there is a normal alignment of the bones and the disks
of the spine and there is plenty of space around the spinal cord
inside the spinal canal. This space contains a fluid called
cerebrospinal fluid that bathes and protects the spinal cord.
The cord floats in this fluid and in the MRI scan, the cord has a
normal, consistent dark appearance and is functioning normally.
This is an MRI scan of a patient with cervical stenosis due to arthritis.
In this image, the disks are degenerating and bulging in towards the
spinal canal and the canal is narrowed.
This patient has cervical spinal stenosis, but they don’t have
cervical myelopathy because the spinal cord still has a normal
consistent dark appearance.
While there is narrowing of the spinal canal, the pressure is not so
severe that the patient needs an operation
In many cases, these patients can be safely watched over several years
to make sure that their condition doesn’t get worse.
In this image, the patient has both cervical spinal stenosis and
Like the previous image, the disks of the neck have degenerated and
they are bulging in towards the spinal canal.
However, in this image, the pressure is so severe that the spinal cord
has been bruised by the constant pressure.
This shows up as a bright white signal in the center of the spinal
cord and this is a condition that needs to be evaluated by a spinal
expert right away.
Cervical myelopathy is a condition that usually needs to be treated
with an operation. The pressure on the spinal cord needs to be
alleviated or the patient’s ability to control their arms and legs
will get worse, and the changes will become permanent.
If the condition is treated early enough…. the numbness and lack of
coordination in the hands should improve.
However, if the pressure has been present for many years, in some
instances the best that we can hope for is that the condition won’t
get any worse.
In any case, if you have cervical spinal stenosis or cervical
myelopathy, you should be seen by someone who is an expert in the
diagnosis and treatment of degenerative spinal conditions right away
We like taking care of patients with cervical myelopathy because in
general they are very pleased with the results of surgery and we like
making people better.
We look forward to having the opportunity to take care of you at
Monterey Spine and Joint
where we believe that a team approach to spinal disorders achieves
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