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Cervical myelopathy and cortical alterations
I have been diagnosed with severe Degenerative Cervical Myelopathy (DCM) and will be having posterior cervical laminectomy (c3-C5) with fusion (C3-C7) surgery in 10 days. I have read that DCM can lead to significant cortical alterations, including thinning, in the brain, according to research from NIH. Specifically, these changes are observed in areas responsible for motor control, sensory processing, and visual function. The research also says that, while less explored, DCM may also impact cognitive and speech functions due to changes in frontal and other cognitive regions.
In the past month I have experienced increased slurring of speech and reduced vocal function, as well as decreased ability to concentrate.
Is this something that may be rectified after my surgery, or has DCM caused enough cortical alteration and reorganization that these cognitive and speech symptoms may be permanent and progressive?
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@dukedevil
I also have degenerative cervical myelopathy.
How long have you had symptoms and how long did it take to get properly diagnosed?
What are your current symptoms in addition to speech/cognitive changes?
I was misdiagnosed for over 5 years and even called a hypochondriac by one doctor (fired her). DCM causes many symptoms and it is hard to properly diagnose. I had symptoms of daily headaches, tinnitus in ears, hearing loss, neck/shoulder/shoulder blade pain/tightness/knots in muscles, slurring of speech and swallowing issues at times, difficulty concentrating/brain fog/memory issues, arm/hand weakness, dropped things and handwriting got much worse, bladder control issues, balance off and dizzy, weakness in legs and a heaviness in legs like I was wearing cement boots when trying to walk, fell a couple times, etc.
After having ACDF fusion surgery on c5-c6, many symptoms improved right after surgery with decompression of my spinal cord. I have some residual shoulder/arm/hand weakness and balance issues which may be permanent. I have some returning symptoms due to a new herniated disc at c6-c7 and having surgery next week.
I also have a congenitally narrow spinal canal and small fiber neuropathy so this adds to my neurological “fun.” 😉
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3 Reactions@ dlydailyhope I first noticed stiffness in my neck with no pain in 2017, but it was in March 2024 when I began to develop radiculopathy on the left side of my neck that produces tingling down to my shoulder and upper arm. That is when I was referred to a spine specialist to evaluate my condition. I spent the next six months going through a series of MRIs of my brain and spine, as well as more x-rays, CTs and neurological tests. It wasn’t until the end of 2024 that a definitive diagnosis of severe cervical myelopathy was made.
Aside from the radiculopathy noted in March 2024, I really didn’t experience any axial neck pain. But I didn’t begin to experience some neurological deficits, such as reduced fine motor ability in my hands and fingers, numbness in my fingers and feet, general weakness in my extremities, gait disturbance and imbalance, and frequent urination. In March 2025, axial neck pain on my left side has also appeared. The previously mentioned speech and cognitive issues are new issues of the past month.
I have consulted and interviewed 4 different spine surgeons, and am going with Dr. John Rhee at Emory because of his extensive credentials in cervical spine surgery and research, as well as his level of empathy and superior patient management skills. He is a recent president of the Cervical Spine Research Society.
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2 Reactionsi had ACDF c4-c7 i think. 5 years ago. got a little better for a year. then regressed. i struggle to walk with a can now and have pain most days. they have no explaination why i got worse after they fixed the compression (doctor said i would never be 100% but i got to like 75%. now like 50%)
@scottd7
Do you know if your spinal cord was injured/flattened and compressed before you had surgery? How long did you have symptoms before surgery and what symptoms did you have pre-surgery?
Have you had a recent MRI of your cervical and lumbar spine to see if you have new compression of your spinal cord/nerve roots? Have you gone to a neurologist for EMG/nerve conduction studies of upper and lower limbs?
My understanding is that with fusion, you are at risk for adjacent segment issues with vertebrae above and below the fusion section. With normal aging and continued degeneration, you may have new disc herniations and/or bone spurs. The alignment of your spine may have shifted.
Have you reviewed all of your MRI reports yourself or had a loved one help you look at everything? It may be good to see a new orthopedic spine specialist/surgeon for 2nd and 3rd opinions.
Are you being cared for by a pain management specialist and are you getting physical therapy?
If your spinal cord and nerve roots have been injured due to long term cord/nerve root compression/flattening, central/peripheral nervous system issues may worsen over time and cause miscommunication between brain and body/organs. This includes pain signals.