Cervical Myelopathy in Singapore

What Are the Symptoms?

• Neck stiffness or discomfort
• Hand clumsiness or difficulty with fine motor tasks
• Unsteady gait or balance issues
• Upper limb weakness or numbness
• Spasticity or exaggerated reflexes

What Are the Risk Factors?

• Age over 50 (degenerative changes)
• Congenital spinal canal narrowing
• Ossification of the posterior longitudinal ligament (OPLL)
• Previous neck trauma or instability
• Asian ethnicity (higher prevalence of OPLL)

What Causes Cervical Myelopathy?

• Degenerative cervical stenosis
• Disc herniation or bulging
• Bone spurs compressing the spinal cord
• OPLL (ossified ligament pressing on the cord)
• Trauma or instability

How Is It Diagnosed?

• Neurological examination (e.g. Hoffman’s sign, gait testing)
• MRI of the cervical spine to assess cord compression
• CT scan for bony narrowing or OPLL
• Electrophysiological studies (if needed)

What Are the Treatment Options?

Non-Surgical Management

• Activity modification and fall prevention
• Physical therapy for balance and coordination
• Medications for spasticity or inflammation

Surgical Intervention

• Anterior cervical discectomy and fusion (ACDF)
• Posterior cervical decompression and fusion
• Laminoplasty (motion-preserving decompression)

Conclusion

Cervical myelopathy is a serious and progressive condition that can affect mobility, dexterity, and independence. At The Scoliosis & Spine Clinic (SG) in Singapore, we offer comprehensive evaluation and tailored treatment plans—from conservative care to advanced surgical decompression. Early diagnosis and timely intervention are key to preserving spinal cord function and long-term quality of life.

Frequently Asked Questions: Cervical Myelopathy

1. What are the common causes of medical myelopathy where surgery is not needed?
Medical myelopathy refers to spinal cord dysfunction caused by non-surgical conditions such as vitamin B12 deficiency, autoimmune disorders, viral infections, or inflammatory diseases like multiple sclerosis. These cases may be managed with medication, rehabilitation, and close monitoring without the need for surgery.

2. What is stretch myelopathy?
Stretch myelopathy is a form of spinal cord injury caused by excessive elongation or traction of the spinal cord, often seen in cases of spinal deformity or instability. It can lead to neurological symptoms without direct compression and may improve with postural correction or bracing, depending on severity.

3. What is the difference between medical myelopathy and surgical myelopathy?
Medical and surgical myelopathy differ in both cause and treatment approach: Medical Myelopathy:

• Caused by systemic or inflammatory conditions
• Examples include vitamin deficiencies, autoimmune diseases, infections, or multiple sclerosis
• Typically managed with medication, rehabilitation, and monitoring

• Caused by mechanical compression of the spinal cord
• Common causes include disc herniation, bone spurs, or spinal stenosis
• Often requires surgical decompression to prevent permanent neurological damage

4. What is the advantage of surgery?
Surgery aims to relieve spinal cord compression, halt neurological deterioration, and restore function. In many cases, timely intervention can significantly improve hand coordination, walking stability, and quality of life.

5. What is the post-op recovery like?
Most patients are up and walking within a few days after surgery. Recovery typically involves physiotherapy, wound care, and gradual return to daily activities. Neurological improvement is unpredictable and may take weeks to months depending on the severity of pre-op symptoms. Recovery is inversely proportionate to the compression.

6. What is the cost of surgery?
The cost varies depending on the procedure type, hospital class, and insurance coverage. Our clinic provides transparent estimates during consultation and can assist with financial planning. Medisave and Integrated Shield Plans may be applicable for eligible patients.

7. What is my down time?
Most patients return to light activities within 2–3 weeks and desk work within 4–6 weeks. Full wound recovery for strenuous tasks may take 2–3 months. Your timeline will depend on your individual condition and surgical approach.

8. Does your clinic help with insurance claims?
Yes. Our clinic is ready to assist with insurance documentation, pre-authorisation forms, and coordination with major providers. We aim to make your treatment journey smooth and stress-free.