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Spinal Cord Compression

CERVICAL SPONDYLOTIC MYELOPATHY

One of the most common neck conditions that occurs with age is cervical spondylotic myelopathy (CSM). Over time, the normal wear-and-tear effects of aging can lead to a narrowing of the spinal canal. This compresses — or squeezes — the spinal cord. CSM can cause a variety of symptoms, including pain, numbness, and weakness (AAOS, 2015). Symptoms usually begin after the age of 50, but can occur earlier if there was an injury to the spine at a younger age. Many people with CSM will have steady progression of their disease. Once symptoms start, they tend to continue. Typically, the disease progresses slowly over several years. In about 5% to 20% of people, CSM worsens more rapidly.

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SYMPTOMS

The spinal cord is the cable of nerves that send and receive signals from the body. When the spinal cord is slowly compressed, people may develop symptoms such as:

  • Tingling and numbness
  • Weakness: trouble lifting objects, dropping things
  • Difficulty walking (loss of balance), wide-based gait
  • Coordination problems/clumsiness: handwriting, buttoning clothes, and feeding oneself can become difficult
  • Neck pain and stiffness

TREATMENT

Nonsurgical Treatment

Some people get relief from symptoms of CSM without surgery. The most common nonsurgical treatment options include:

  • Soft Collars. Soft collars allow the muscles of the neck to rest by limiting neck motion. This can help decrease pinching of nerve roots with movement. Soft collars should only be worn for short periods of time, because long-term wear can decrease the strength of neck muscles.
  • Exercise. Improving neck strength and flexibility with simple exercises may lessen discomfort.
  • Nonsteroidal anti-inflammatory medications (NSAIDs). Drugs like aspirin and ibuprofen can reduce swelling and painful symptoms of spinal cord compression.
  • Epidural steroid injections. Cortisone is a powerful anti-inflammatory. Cortisone injections in the “epidural space” can decrease swelling as well as pain, although they are not often used in CSM.
  • Chiropractic manipulation. Manipulation is never used if a patient has spinal cord compression.

 

Surgical Treatment

Whether to have surgery or not is a complex decision made between you and your doctor. Learn more about surgical options for cervical spondylotic myelopathy.

RISK FACTOR

Risk factors for CSM include:

  • Normal age-dependent changes of the intervertebral discs, most commonly manifested as cervical osteophytes (bone spurs) at the margins of the vertebrae.
  • Arthritis in the spine leading to facet hypertrophy i.e. enlargement of the facet joints.
  • Thickening of the ligaments surrounding the spinal canal, especially the ligamentum flavum, which parallels loss of disc height.
  • Translational mechanical instability resulting in subluxation (or partial dislocation) of the vertebral bodies.
  • Congenitally small spinal canal, which renders the patient’s spinal cord more susceptible to compression.
  • Repetitive wear and/or trauma leading to degenerative changes affecting the disc spaces and vertebral endplates.

 

Orthopedic Spine Surgeon Dr Hamid R. Mir M.D.

Meet

Dr. Hamid R. Mir M.D.

Orthopedic Spine Surgeon & Back, Spine, & Neck Specialist

Dr Hamid Mir is a board certified orthopedic spine surgeon & back, spine, & neck specialist with fellowship training in combined neurosurgery and orthopedic spine surgery. He has offices in Orange County, Los Angeles & Riverside. Dr Mir specializes in spinal fusion, lumbar surgery and treating trauma as well as other conditions affecting the lumbar, thoracic, and cervical spine including degenerative diseases, stenosis, fracture, infection, adult scoliosis, revision, and complex reconstructions.

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Testimonials

You are more than just a patient.

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I was in a very bad situation with a herniated disc in my lower back so I made an appointment with DISC spine center and Dr. Hamid. He was very professional and made me comfortable that he understood exactly what I was going through and was able to communicate effectively exactly what it will take to get me on the road to recovery after spine surgery. It took several months as my injury was severe however I always felt I was in good hands under Dr. Hamid’s supervision…If you ever have the misfortune of injuring your circuit board of your body (spine) you need a pro, do not take advice from anyone who’s not specifically licensed to help, Dr Hamid is who I chose and I’m very thankful.

- Matteo B

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Dr. Mir saw me about 2 months before the spine procedure and indicated that I had severe stenosis or narrowing of the openings where the nerve roots exit at the L4, L5 and S1 level. He reviewed my MRI and without wasting any time, asked if I wanted or was considering spinal surgery. He was extremely clear and answered all my questions. I had the procedure done at the Disc Newport OP surgery spine center and was cared for by an incredibly competent, caring staff. I was discharged same day and my post op recovery was 2 weeks, and returned to daily activities and work July 15th. The procedure was very successful as my back pain is basically gone. Amazing relief from a procedure done by a great surgeon with a great team!

- Stan W.

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Dr Mir is an excellent spine surgeon. I had a surgery on my neck by another surgeon but I was still in pain. A friend who had prior spine surgery with Dr. Mir recommended him to me. As the treating surgeon he was very detail oriented, confident, and knowledgeable. His team is very friendly and helpful. I decided to have a second cervical spine operation on my neck. Soooo thankful I have no pain and for physical medicine doctors like him.

- Hillary C.

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Dr. Mir and his entire team of specialists take the extra time and consideration to shape alternatives to meet the needs (holistically) of the patient. Everything about the experience of my surgery was positive. Dr. Mir is a patient and compassionate surgeon. His communication skills are remarkably attentive. We are six months out of the starting gate from surgical treatment, and with PT and core strengthening exercises, this 65 yr. old is back to regular training for next year’s marathon. Thank you kindly El Doc-tor….you are amazing! See you soon.

- Lorena B.

Dr. Hamid Mir is a member of American Board of Orthopedic Surgery with fellowship training in combined neurosurgical and orthopedic spine surgery at Cedars Sinai Medical Center in 2004. As a top rated spine surgeon, he specializes in cervical, thoracic, and lumbar spine diseases including degenerative, stenosis, fracture, infection, scoliosis, revision, and complex reconstructions.

Dr. Mir focused his practice on minimally invasive techniques. As Medical Director of DISC Sports & Spine Center, Dr. Mir is at the forefront of the field of minimally invasive spine surgery. The benefits of these techniques include less post-operative pain, quicker recovery reduced blood loss, less soft tissue damage, smaller surgical incisions, less scarring and improved function.

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