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Cervical Spondylotic Myelopathy Treatment

Orthopedic Surgery

How is Cervical Spondylotic Myelopathy treated without surgery?

In milder cases, CSM can be treated without surgery. The goal of nonsurgical treatment is to decrease pain and improve the patient's ability to perform daily activities. Nonsurgical treatment options include:

  • Soft cervical collar. This is a padded ring that wraps around the neck and is held in place with velcro. Your doctor may advise you to wear a soft cervical collar to allow the muscles of the neck to rest and limit neck motion. A soft collar should only be worn for a short period of time since long-term wear may decrease the strength of the muscles in your neck.
  • Physical therapy. Specific exercises can help relieve pain, strengthen neck muscles, and increase flexibility. Physical therapy can also help you maintain strength and endurance so that you are better able to perform your daily activities. In some cases, traction can be used to gently stretch the joints and muscles of the neck.
  • Medications. In some cases, medications can help improve your symptoms.
  • Nonsteroidal anti-inflammatory medications (NSAIDs). Drugs like aspirin, ibuprofen, and naproxen can help relieve pain from reduce inflammation.
  • Oral cor ticosteroids. Oral corticosteroids may help relieve pain by reducing inflammation.
  • Epidural steroid injection. Although not often used to treat CSM, in this procedure, steroids are injected into the space next to the covering of the spinal cord (the "epidural" space) to help reduce local inflammation. Although a steroid injection may temporarily help relieve pain and swelling, it will not relieve pressure on the spinal cord.
  • Narcotics. These medications are reserve for patients with severe pain that is not relieved by other options. Narcotics are usually prescribed for a limited time only.

How is Cervical Spondylotic Myelopathy treated with surgery?

If nonsurgical treatment does not relieve your symptoms, your doctor will talk with you about whether you would benefit from surgery. The majority of patients with symptoms and tests consistent with CSM are recommended to have surgery.

There are several procedures that can be performed to help relieve pressure on the spinal cord. The procedure your doctor recommends will depend on many factors, including what symptoms you are experiencing and the levels of the spinal cord that are involved.