“Keep it simple, individualized, customized and safe by intervening only when needed and then with the least damage to uninvolved tissue as possible. “ David R. Campbell, MD

Cervical Spine Myelopathy and Radiculopathy

These terms are commonly used by spine surgeons to explain a medical condition where the spinal cord or the spinal nerves in the neck are not functioning properly.  These are Latin derived terms that need some explanation.

The cervical part of the spine is the neck.  The spine is comprised of vertebrae, spinal cord, spinal nerves and discs. The vertebrae are composed of bone. The spinal cord is a long bundle of nerve tissue serving as a major conduit for nerve impulses from the brain to the body.   The spinal cord represents the word “myelo”.   The term “pathy” means messed up, diseased, pathologic and improperly functioning.  Combined you get myelopathy.   The nerve roots branch out of the spinal cord.  When the nerve roots become a problem, it is given the term radiculopathy.  If the spinal cord and the spinal nerves are functioning abnormally, it is described as myeloradiculopathy.

This week I saw quite a few patients in my office that had cervical spine issues.  One patient, with an artificial disc implanted a few years ago still had significant pain in her neck.  On the front cover of The Spine Journal  issue of November 2012, appeared an ad about a cervical artificial disc  that provides Selectively Constrained Motion, an alternative to cervical spine fusion.  This particular patient had an artificial disc implant in her neck that was intact and functioning; continued to be in significant pain; was now using opiate narcotic pain medications daily to alleviate the pain.

With modern technology replacing a living and injured intervertebral disc in the neck with plastic and metal, how is it that this patient is still experiencing pain?  The possible answer may be that there is easy availability of strong pain medications or it could be an arthritic and degenerative condition that has developed in another part of the cervical spine.

This is a gentle reminder that spine surgery does not always solve every spine problem.   Spine surgery may be an option to enable you to function and feel better, but limit your expectations about spine surgery.  If you want perfection,  buy a Mercedes Benz.

David R. Campbell, MD
MAJ (Ret), MC, USAR

Board Certified Orthopedic Surgeon

Fellowship Trained Spine Surgeon