The Lowdown on Low Back Pain
(and Other Aches)


My neck hurts, my arms are weak, and my legs are stiff. Why?

You may have a spinal cord injury in your neck. Arthritis (or disc problems) in the neck can cause damage to just one nerve or to the entire spinal cord. When one nerve is pinched, there may be numbness in one part of the arm or weakness in one muscle. When the spinal cord is pinched, a “myelopathy” can develop. The arms may hurt because of pinched nerves. The legs will become stiff due to pressure on the spinal cord itself. Loss of coordination is also common.

Myelopathy can come on slowly or be the result of an injury. A history of a fall with the neck extended is common. An MRI of the neck ordinarily shows the problem. The MRI will show a smaller than normal spinal canal. It can show a spinal cord bruise. X-rays, an EMG, and other studies are sometimes needed.

When there is a myelopathy, surgery is usually required. The operation may be done from either the front, from the back, or using a combination. The posterior (back) surgery is more painful but does not require a fusion. It is used when many levels are abnormal. The anterior surgery uses minimally invasive and bloodless techniques. It is less painful and requires less time in the hospital. Although it does involve fusion, it is not necessary to use your own hip for bone. The hip graft is painful and there are now good alternatives to your own bone.

Although the prospect of neck surgery can be terrifying, the results of the operation are good in over ninety percent of patients. One should pick the least invasive surgery and avoid the use of a hip graft if possible.



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Last modified: 07/27/08