Cervical Myelopathy in Singapore
Understanding Symptoms, Causes, and When to Seek Specialist Evaluation
By Dr Lau LL | Singapore | Published on 3 September 2025 | Last modified on 21 April 2026
Cervical myelopathy is a progressive condition caused by compression of the spinal cord in the neck. It can affect hand coordination, balance, and overall mobility. Early recognition and timely evaluation are important to protect long‑term neurological function. This article provides evidence‑based information to help individuals understand how cervical myelopathy presents and how it is typically assessed in Singapore.
Patient Feature: Warren’s Story
Warren, a 68‑year‑old retiree, began noticing difficulty walking in a straight line and veering sideways without realising it. Simple tasks such as buttoning his shirt or using chopsticks became unexpectedly challenging. Concerned by the rapid changes, his wife brought him to their GP, who recognised the seriousness of his symptoms and referred him to a spine specialist.
After clinical assessment and imaging, Warren was diagnosed with cervical myelopathy. His story highlights the importance of early recognition and timely specialist evaluation, especially when symptoms evolve quickly.
What Are the Symptoms?
- Neck stiffness or tightness
- Hand clumsiness or difficulty with fine motor tasks
- Unsteady gait or balance problems
- Weakness, numbness, or reduced coordination in the arms or hands
- Spasticity or exaggerated reflexes
What Are the Risk Factors?
- Age above 50 (degenerative changes)
- Congenital narrowing of the cervical spinal canal
- Ossification of the posterior longitudinal ligament (OPLL)
- Previous neck trauma or instability
- Asian ethnicity (higher prevalence of OPLL)
- Conditions associated with skeletal dysplasia
What Causes Cervical Myelopathy?
- Degenerative cervical spinal stenosis
- Disc herniation or disc bulging compressing the spinal cord
- Bone spurs (osteophytes) narrowing the spinal canal
- OPLL causing progressive pressure on the spinal cord
- Trauma, instability, or ligamentous thickening
How Is It Diagnosed?
- Neurological examination (e.g., reflexes, gait assessment, Hoffman’s sign)
- MRI of the cervical spine to evaluate spinal cord compression
- CT scan to assess bony narrowing or OPLL
- Electrophysiological studies when diagnostic clarification is needed
What Are the Treatment Options?
Non‑Surgical Management
- Activity modification and fall‑risk reduction
- Physiotherapy focusing on 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 condition that can affect mobility, hand function, and overall independence. Early recognition and timely evaluation are important to protect spinal cord function. For individuals seeking more information about spine conditions, you may learn more about the author here: Dr Lau LL – Profile Page.