Symptoms of cervical stenosis with myelopathy tend to develop slowly over time, but they also can have spurts of rapid progression or periods of stability without worsening. The timeline for symptom progression can vary widely from person to person.
Common Symptoms of Cervical Stenosis with Myelopathy
People with cervical stenosis with myelopathy may not recognize the slow onset in the early stages. A minor change in handwriting or taking more time to get dressed in the morning, for example, may be too subtle to notice. Over time, symptoms are likely to become more noticeable and could include one or more of the following:
- Weakness or numbness. Hand weakness or numbness can get bad enough to affect grip. These symptoms could also be experienced in other parts of the body, such as the arms or legs.
- Reduced fine motor skills. The person might encounter more trouble with typing, handwriting, buttoning a shirt, or putting a key in a door.
- Changes in walking. The legs could feel heavy or the individual could find it impossible to go faster. Balance problems may occur if the legs are not going where intended, requiring more reliance on a walking cane and/or hand rails.
- Neck pain or stiffness. The neck may be sore or have reduced range of motion. In some cases, the neck may make grinding sounds, called crepitus, with certain movements.
- Nerve pain. Intermittent shooting pains resembling an electric shock may extend into the arms and legs, especially when bending the head forward (known as Lhermitte phenomenon). If a nerve root is also being impinged, cervical radiculopathy symptoms of pain, tingling, weakness, and/or numbness may also be felt down the arm and/or into the hand.
Cervical myelopathy does not typically cause symptoms until the spinal cord is compressed by at least 30%.1 Anterior (front) spinal cord compression tends to cause motor dysfunction, and posterior (back) spinal cord compression tends to cause sensory deficits.2 It is possible for the cord to be compressed in both the front and back.
Arm pain is often the first symptom that prompts someone to seek medical treatment for this condition. Cervical stenosis with myelopathy is then discovered through medical history and the physical exam. Although, sometimes pain is not present with cervical myelopathy, which might lead to a delay in seeking treatment.
Severe Symptoms of Cervical Stenosis with Myelopathy
If cervical stenosis with myelopathy continues to progress and further compresses the spinal cord, severe symptoms can eventually develop in the latter stages. These could include:
- Incontinence. Difficulties may occur with bladder and/or bowel control.
- Paralysis. Weakness and numbness in any or all limbs can completely lose function and sensation. Other parts of the body could also be susceptible to developing full paralysis anywhere beneath the level of spinal cord impingement.
In most cases, a person can get an accurate diagnosis and successful surgical treatment to decompress the spinal cord before incontinence, paralysis, or other severe symptoms of cervical myelopathy occur.