Myelopathy is a serious condition caused by compression of the spinal cord, most commonly in the cervical (neck) or thoracic (mid-back) spine. This pressure can lead to symptoms such as weakness, numbness, difficulty with coordination, and progressive functional decline if left untreated. Aqib Zehri, MD, is a fellowship-trained neurosurgeon in Portland, Oregon, specializing in complex spine conditions, including cervical and thoracic myelopathy. He provides comprehensive evaluation and offers targeted treatment options, including advanced surgical and minimally invasive techniques to relieve spinal cord compression and preserve neurologic function.
Myelopathy occurs when the spinal cord becomes compressed, disrupting communication between the brain and the rest of the body. It most commonly develops in the cervical spine (neck) but can also occur in the thoracic spine (mid-back).
Common causes include:
Degenerative disc disease
Bone spurs (osteophytes)
Thickened ligaments
Spinal stenosis
Herniated discs
Spinal tumors
Because the spinal cord controls movement, sensation, and coordination, compression can lead to progressive neurologic symptoms if not treated.
Symptoms often develop gradually and may worsen over time. Unlike isolated nerve compression, myelopathy affects spinal cord function and can impact both sides of the body.
Common symptoms include:
Weakness in the arms or legs
Numbness or tingling in the hands or feet
Difficulty with balance or walking
Loss of coordination or clumsiness
Changes in fine motor skills (such as difficulty with buttons or handwriting)
In more advanced cases, patients may develop:
Gait instability or frequent falls
Loss of bowel or bladder control
Recognizing early symptoms is important, as myelopathy can progress over time.
Early signs may include:
Subtle balance issues or unsteadiness
Hand clumsiness or difficulty with fine motor tasks
Mild numbness or tingling in the hands
Neck stiffness with coordination changes
Advanced signs may include:
Significant weakness in the arms or legs
Difficulty walking or frequent falls
Loss of hand function
Loss of bowel or bladder control
Progression can vary, but early evaluation is important to prevent permanent spinal cord injury.
Diagnosis begins with a detailed history and neurologic examination, including assessment of:
Strength
Reflexes
Sensation
Coordination and gait
Imaging is essential to confirm spinal cord compression and identify the underlying cause:
MRI to evaluate the spinal cord and soft tissues
CT scans to assess bony structures when needed
These studies help determine the location and severity of compression and guide treatment planning.
Surgery is often recommended for myelopathy because spinal cord compression can lead to progressive and potentially irreversible neurologic decline.
Surgical treatment may be indicated when there is:
Evidence of spinal cord compression on imaging
Progressive symptoms over time
Objective neurologic deficits (such as weakness or coordination problems)
Difficulty with walking, balance, or hand function
Unlike some other spine conditions, myelopathy is less likely to improve with conservative treatment alone. The goal of surgery is to:
Relieve pressure on the spinal cord
Prevent further neurologic deterioration
Stabilize the spine when necessary
In many cases, surgery is recommended even when symptoms are mild but progressing, to prevent long-term impairment.
Treatment focuses on relieving pressure on the spinal cord and preserving neurologic function.
Surgical options are designed to decompress the spinal cord and may include:
Anterior decompression procedures
Posterior decompression procedures
Stabilization when needed
Dr. Zehri specializes in complex spine surgery and selects the appropriate approach based on:
Location of compression
Spinal alignment
Severity of neurologic involvement
When appropriate, minimally invasive techniques may be utilized to reduce tissue disruption and support recovery.
Because myelopathy can progress over time, early evaluation is important to prevent permanent neurologic injury.
Call the office or request an appointment online to get started.