Spinal myelopathy ... early surgical intervention may help stop the disease and prevent its deterioration! The last issue dealt with a spinal cord disorder and confirmed that it may occur as a result of slow and chronic narrowing of the spinal canal through which the spinal cord passes into the cervical vertebrae. This narrowing occurs as a result of many factors, including chronic stress, stiffness of the cervical vertebrae, herniated disc in the cervical vertebrae, and some genetic diseases that cause narrowing of the spinal canal or in some rheumatic diseases that cause narrowing of the spinal canal. This narrowing over time leads to suffocation in the spinal cord passage area and pressure on the spinal cord, thus until the effects of this pressure begin to affect the functions of the spinal cord. We also talked about symptoms and diagnosis, and to complement this, we are dealing with the treatment plan today. In cases where the symptoms are simple and not severe, the disease is in its beginnings, the non-surgical conservative treatment can be tried by doing physical therapy sessions to strengthen the neck muscles, which leads to relieving the pressures that reach Spine and spinal cord. In addition, physical therapy helps to strengthen the peripheral muscles in the hands and arms, restore flexibility and ease of movement in the joints, and relieve tension and stiffness in the surrounding muscles in the neck. Painkillers, anti-inflammatory drugs for joints, muscles, and muscle relaxants can also be dispensed to patients who take them as needed. Also, regular doses of vitamin B complex can be given, which is important for nourishing the nervous system and nerves. In addition, warm patches, ointments, and compresses help relieve pain and remove tension from the muscles. There are some medicines specialized in relieving the pain resulting from pressure on the nerves and resulting from myeloid myelopathy, such as Lyrica. In many patients, the condition stabilizes and may improve over time. As for the cases in which the symptoms are severe and do not respond to the plan that we mentioned earlier, or in which the patient comes and the condition is advanced and he cannot walk and the effects of the illness are clear on the upper and lower extremities, then in these cases surgical intervention may be resorted to.
Surgical intervention
Unfortunately, myeloid myelopathy in the cervical vertebrae when it occurs and when the nerve cells that pass from the spinal cord are affected, the vast majority of this vulnerability, morbidity and disease are permanent and the cells do not return to their normal condition. For this reason, the disease must be detected early and treated early, and if the need calls for early surgical intervention to stop the disease from deteriorating because if the disease deteriorates, progresses and worsens the patient’s condition, then surgical intervention will not be beneficial because the cells have been affected permanently, as mentioned previously. But when surgical intervention is done in a timely manner, it prevents the deterioration of the disease and prevents the increase in symptoms, and in some cases it may lead to a clear and tangible improvement in the condition of the patient or the patient, and it may lead to a decline in symptoms, God willing. And the surgical intervention is usually in the form of expansion of the spinal canal through which the diseased spinal cord passes, which leads to raising pressure on this spinal cord and increasing the space in the distance that the spinal cord passes through. In addition, in most cases, internal fixation is performed for the diseased parts of the spine for which an expansion of the spinal canal has been performed. This fixation removes pain from the neck area and ensures the stability of the vertebrae and ensures that the spinal cord is not affected as a result of removing parts of the vertebral-forming bone when expanding the spinal canal.
Method of surgical intervention
There are two main ways to perform this surgery which, as mentioned earlier, consists of decompressing the spinal cord, expanding the spinal nerve canal through which the spinal cord passes, and stabilizing the diseased vertebrae.
The first method is to perform this operation through the posterior entrance to the cervical vertebrae, where the incision is at the back of the neck, which extends from under the hairline at the back of the head to the upper back. In this surgery, pressure can be removed from three, four or five vertebrae pressing on the spinal cord, and fixation of more than one vertebra can be done easily, God willing. The other way is to enter the vertebrae and spinal cord through the anterior entrance to perform surgery in the anterior region of the neck, after which parts of the vertebrae and cartilage that are responsible for pressure on the diseased spinal cord are removed, and then these cartilages and vertebrae are replaced by specialized medical metal cages or bone graft. This anterior method is preferred if there is only one or two areas of the spinal cord being compressed. In both cases, a medical collar is placed after the operation for a period of six weeks, and a physical therapy program is made for patients after surgery to strengthen the muscles, restore flexibility and movement of the joints of the hands, arms and legs, and enable the patient to gradually return to walking. These operations are major but routine surgeries in the spine, and they have a high success rate, God willing, especially if the disease is discovered and surgery is performed in the early stages before the spinal cord cells have become permanently damaged.
