But the earlier you intervene, the better the outcome.Cervical Spine MRI Scan What is a cervical spine MRI scan?Ī Magnetic Resonance Imaging (MRI) scan makes use of a combination of radio waves and magnets to capture images of the inside of the body. "Cervical myelopathy really sneaks up on people. "Unfortunately, by the time some patients get to us, they are very debilitated," Dr. Some individuals become wheelchair dependent. But I can't button my shirt or put my earrings in.' Or 'My handwriting has gotten bad' or 'My balance isn't quite what it used to be and I am having more falls.' Those problems should trigger physicians to think about cervical myelopathy."Īs the disease progresses, symptoms can include upper extremity numbness, neck pain and gait disturbance. "Patients tell us, 'There's nothing wrong with my neck. "The disease process isn't generally associated with pain," Dr. The most common early sign of the disease - loss of dexterity - can be attributed by patients and even physicians to normal aging. "We would also like to find a way to screen patients and catch CSM early." The importance of early interventionĭiagnosis of cervical myelopathy is often delayed. "We hope to learn if there's an adjunct treatment we might give these patients before or after surgery to help their recovery," Dr. Mayo Clinic is enrolling patients in a new study to determine how the polymorphism might affect the recovery process of people with CSM. Abode-Iyamah and colleagues implicated a mutation known as Val66Met polymorphism in the pathophysiology of cervical spondylotic myelopathy (CSM). "The goal is to return the patient's spine to the best alignment that will minimize stress and strain on the spinal cord."Īnother area of interest is a genetic component to cervical myelopathies. "These results have the potential to change our approach in treating these patients," Dr. The researchers also found that double-door laminoplasty allowed for more normal motion of the spine, as that procedure doesn't fuse the vertebral bodies. Increased canal width allows for more spinal cord displacement, especially in extension, which may decrease the likelihood of spinal cord impingement elsewhere along the canal. The researchers suggest this might be due to a lack of spinal canal widening in the procedure compared with ACDF with laminectomy or double-door laminoplasty. "While the area that was decompressed showed decreased strain, other areas of the spinal cord started to see new stress."Īmong all the surgical techniques studied, anterior cervical diskectomy and fusion (ACDF) increased adjacent-level strain and stress the most. "But interestingly, we also found that surgery didn't necessarily eliminate all the strain on the spinal cord," Dr. The model, described in a study published in the February 2020 issue of Clinical Biomechanics, predicts how common surgical interventions affect spinal cord mechanics.Īs expected, the study found that after surgery, patients had decreased spinal cord movement in the surgical area. To that end, Mayo Clinic is using the first finite element model of the healthy and myelopathic C2-T1 cervical spine. "If surgery doesn't optimally position the spinal cord, the patient can have ongoing and worsening symptoms of myelopathy." "We want to better understand how much stress is actually on the spinal cord so we can determine the best surgical approach for each patient," says Kingsley Abode-Iyamah, M.D., a neurosurgeon at Mayo Clinic in Jacksonville, Florida.
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