Treatment in Dubai
Cervical Myelopathy refers to compression of the cervical spinal cord. It is a common form of neurological impairment most commonly present in older patients with gait imbalance, hand clumsiness, symmetric numbness, and tingling in the extremities. Non-operative treatments and surgical decompression and stabilisation are the most recommended cervical myelopathy treatments in Dubai.
What Causes Cervical Myelopathy?
Cervical myelopathy symptoms occur whenever there is gradual wear and tear of the spine. The prevalent causes of cervical myelopathy are as follows:
Cervical Spondylosis: Narrowing of the spinal canal size often results from degenerative changes in the cervical spine anatomy, which occurs with ageing. This narrowing typically occurs due to a combination of disc bulges, overgrown facet joints, bone spurs, and ligament hypertrophy (overgrowth).
Ossification of posterior longitudinal ligament (OPLL)– Soft tissue that connects the spinal column’s bones becomes less flexible and gradually turns into bone. The neck portion of the spine is the most common location for OPLL ossification.
Other less prevalent causes of cervical myelopathy are:
- Spinal infections
- Rheumatoid arthritis of the neck
- Whiplash injury or other cervical spine trauma
- Tumours in the spine caused by cancer
What are the symptoms of Cervical Myelopathy?
The cervical myelopathy symptoms are as follows:
- Neck pain and stiffness
- Reduced range of motion of the neck
- Clumsiness or weakness in hands
- Numbness or tingling in hands and arms
- Weak grip
- Increased reflexes in the lower and upper extremities
After studying the patient’s general health and medical history, the following tests are performed for diagnostic purposes:
Physical tests involve inspection of the patient for any abnormalities. In addition, various tests and observations are performed to understand the reflexes, muscle strength, and sensations felt in the arms and legs.
MRI (Magnetic Resonance Imaging) scanning is considered the best imaging technique for confirming the presence of spinal canal stenosis, cord compression, myelomalacia, and even spinal cord tumours. Some other additional diagnostic studies that can be performed for a detailed and thorough neurological examination are as follows.
- X-rays are used to produce images of dense structures. They can be useful in assessing the overall alignment of the cervical spine and what range of motion remains (flexion-extension X-rays).
- CT (Computerized tomography) scans are used to generate more detailed pictures of the bony cervical spine to determine the anatomy associated with the nerve root and spinal cord compression.
- Somatosensory Evoked Potentials (SSEPs) or motor evoked potentials (MEPs) measure the electrical conductivity of the spinal cord across the compressed segments. These are used to determine how well the nerves in your arms and hands communicate with your brain through the spinal cord.
Cervical Myelopathy Treatments in Dubai
The goal of non-surgical treatment is to decrease pain and improve the patient’s functioning in activities of daily living.
Non-surgical treatment generally comprises a combination of medications and physiotherapy.
Non-steroidal anti-inflammatory medications may be used if there is no contra-indication or risk of significant side effects. Various home exercises and physiotherapy forms can also be undertaken depending on the specific MRI or CT myelogram findings. However, research findings are not generally supportive of traction for cervical myelopathy treatment. Having said that, only your doctor will be in the right position to determine the best-suited cervical myelopathy treatment line for you.
Depending on factors such as symptoms and location of the problem, as well as the overall health of the patient, the following surgeries can be performed:
Laminectomy (approaching the cervical spine from the back)
Laminectomy ensures the complete decompression of the spinal cord if the majority of the compression lies at the back of the spinal cord, or if several levels are involved. This process involves removing the bony arch that forms the back of the spinal canal, along with the bony spurs and ligaments responsible for compressing the spinal cord.
Laminoplasty is an alternative to laminectomy in which the spinal canal is thinned on one side and then cut on the other side instead of removing the bone. This allows the widening of the spinal canal without removing too much bone.
Laminectomy & Spinal Fusion
Laminectomy and spinal fusion is the standard treatment when an approach from the back of the spine is required. Adding a fusion reduces the risk of post-laminectomy kyphosis, where the head tilts forward.
Anterior Cervical Discectomy and Fusion
Anterior Cervical Discectomy and Fusion (or ACDF) is the most common operation performed from the front of the cervical spine. This is typically used when it is disc material compressing the spinal cord. This may be done at one, two, three, or even more levels.
Cervical Corpectomy and Anterior Column Reconstruction
A corpectomy removes the vertebral body with the disc on either side. This is sometimes required depending on the nature of the compressive material, for example, a spinal tumour. Following the removal of the vertebral body, a cage is inserted to replace it. This is usually aided by a plate or screws to hold it in place.
Occasionally patients may require a combination of anterior (front) and posterior (back) approaches.
Who is a candidate for cervical myelopathy surgery?
A patient who shows progressive neurological changes along with the symptoms of spinal cord compression or spinal cord swelling can be considered a candidate for cervical myelopathy surgery. Surgery is often necessary to eliminate the spinal cord’s compression and prevent the condition from worsening further.
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Dr Sherief Elsayed for Cervical Myelopathy Treatment in Dubai?
Dr Sherief Elsayed is a well-recognised spinal surgeon in Dubai for cervical myelopathy pain treatment. He has a significant clinical success record in performing surgeries to treat patients suffering from cervical Myelopathy in Dubai. His patients’ reviews are testimony to his caring, confidential, and discreet approach.
Book an appointment with Dr Sherief to discuss your spine problems now.