Cervical spondylotic myelopathy (CSM) is a neck condition that is most common in patients aged 50 and older. At EvergreenHealth we diagnose and treat hundreds of patients with CSM each year.


What is it?

CSM occurs when the spinal cord in the neck is compressed or squeezed. Typically, this happens with the normal wear and tear of our spine as we age.

It is one of the reasons it is most common to see myelopathy in patients aged 50 years and older.


What causes it?

CSM is caused by degenerative changes that occur with age. The deterioration of the disc is called spondylosis.

It is normal for disks to deteriorate as we age. Nearly half of all middle-aged people ages 50 and older have worn disks, although they do not always cause symptoms. It is not known why some people develop painful symptoms of CMS and others do not. When the normal flow of nerve impulses in the spine is disrupted due to spinal compression, symptoms may develop.

Less common causes of CSM include trauma or injury to the spinal cord, a complication of surgery, genetic causes or CSM that is present at birth.


What are the signs and symptoms?

The spinal cord carries nerve impulses throughout the body. When a patient’s spinal cord becomes compressed, it can cause a variety of symptoms, ranging from mild to more severe.

These symptoms may include:

  • Weakness and numbness in the hands and arms
  • Difficulty walking without vertigo or dizziness
  • Lack of coordination in the hands and/or legs
  • Neck pain or stiffness
  • Arm pain that radiates down the arm to the fingers

How is it diagnosed?

Your doctor will first conduct a medical history and physical examination. At times, imaging is needed to assist in diagnosis.


What are the treatment options?

Treatment of your myelopathy will depend on its severity. A variety of nonsurgical and surgical treatment options are available.

Nonsurgical treatment. Your doctor may take a more conservative approach and recommend treatment aimed at reducing nerve inflammation and your overall pain. Treatment may include a combination of anti-inflammatory medications such as ibuprofen, physical therapy and injections.

Surgical treatment. Surgery is typically reserved for patients who show signs of nerve injury or who do not respond to nonsurgical treatment. Surgery may include spinal fusion, a process in which the vertebrae is fused together so they can heal into a single, solid bone, while removing the pressure off the spinal cord.


What is the long-term prognosis?

No matter what treatment method is used, our goal is to prevent symptoms from worsening. The overall prognosis will vary from patient to patient.

Your doctor will discuss your individual case and give you more information on what you expect before and after treatment.