Physical Therapy and Rehabilitation Specialist Associate Professor Ahmet İnanır gave important information about the subject. Canal stenosis and hernia in the neck usually cause various complaints due to compression of the nerve root or spinal cord. Unfortunately, spinal cord compression is a condition that should be taken very seriously because of the possibility of causing a serious problem such as myelopathy. Almost half of these patients have neck or arm pain.
When myelopathy develops, the patient begins to complain of weakness and clumsiness in the arms. Loss of skill begins in the hands and he cannot open the Jar lid or button his shirt.
In further periods, complaints about the legs begin. Difficulty walking (weakness in the legs), shaking when starting to walk, urinary and defecation incontinence may develop.
The most common cause of this is the chronicization of the situation and accidents by trying to treat patients by incompetent jobs.
This situation differs in each patient. For this reason, since it is difficult to predict which patient will develop this condition, it is necessary to exhibit a very serious treatment and control approach to each patient. Every patient should be concerned that their condition may become this, and they should have their treatments with competent physicians consciously.
When the patient comes to the examination, we see that these patients receive treatment in many places, and although their complaints occasionally decrease, this situation progresses insidiously. And unfortunately, it is not possible to eliminate the advanced situation that develops in these patients. Once it is in this state, we are trying to not only progress. Complete recovery after the development of myelopathy is unfortunately very, very rare. In fact, if these patients were treated and controlled in competent hands, they would not have come to this state.
75% of the patients who have come or have been brought into this state have worsening with attacks, and around 20% have severe worsening. The serious aspect is that 5% of the patients who have become in this situation can suddenly get worse.
As the condition progresses, both legs become weaker and spastic. In addition, urinary and stool incontinence can also develop.
In the diagnosis of patients with myelopathy, MRI (showing signal changes in the spinal cord), CT shows the compressed spinal cord in detail. With EMG and SEP, the problem is examined in detail and the patient's condition is revealed.
Since myelopathy will not improve with surgery, a careful decision should be made in the treatment. If there is a situation that will advance the myelopathy, the decision for surgery should be given priority. In a patient who has developed myelopathy, the patient's condition may also be in a position that will not advance the myelopathy, which is seen in compression due to hernia. In this case, it is more appropriate to get away from surgery and conservative treatment option.
Here, the reasons that compress the spinal cord are of great importance. In myelopathies caused by ligament, bone and joint enlargement, canal stenosis should be opened with surgery. The aim of surgery is not to correct myelopathy, but to prevent deterioration.
Unfortunately, the treatment of these patients is not satisfactory in most patients. Accidents, uninformed interventions by people who are not physicians, and ancillary health personnel trying to treat with incomplete information can make this situation. In order not to come to this situation, patients with neck problems must be under the treatment and supervision of a competent doctor.
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