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How to treat cervical spondylotic myelopathy?

Q: I am getting tingling and numbness of left thumb and pointer finger for the past 5 years which I thought was due to my diabetes. Now I am getting similar sensation in the left toe. I consulted a doctor who ordered MRI of cervical spine. The report of MRI is as follows: 1. Disc osteophyte sandwiches at C3-C4 to C6-C7 levels causing impingement over thecal sac and traversing nerve roots; 2. Central and left paracentral PID at C7-D1 level causing impingement over thecal sac and traversing nerve roots (Lt>Rt); 3. Intervertebral spurs at C3 to C7 level; 4. Diffuse flavum hypertrophy impinging on the cord posteriorly; 5. Focal intracord substance T2 hyperintensity in cervical cord from C3 to C6 level suggestive of myelomalacia; 6. Others normal. My doctor suggested laminectomy. But I am afraid of surgery due to my age (70 yrs) and diabetes. I do not have any pain so far except tingling in fingers. Kindly advise me whether it can be cured by medicines? What precautions should I follow? What are the repercussions if I do not opt for surgery? What are the post-operative complications? Can you suggest any exercises or further management?

A:It sounds as if you have cervical spondylotic myelopathy - that is damage to your spinal cord because of wear and tear in your neck bones. If your hands and legs are getting weaker (or clumsy and stiff) then surgery is often very helpful. You could wear a (neck) collar instead and see if that helps. Surgery is only indicated if your hand (& arms) and legs are getting worse. I would avoid surgery if they are not, because there is a 5% risk of it being made worse (paralysis) from surgery.


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