Cervical myelopathy and cognitive dysfunction

@marycdickens01, allow me to bring fellow members @akc @rjdm1 @quark @ray666 who have experience with cervical myelopathy into this discussion.

Dealing with chronic and persistant pain can affect cognitive function. I assume you are dealing with pain. How do you manage it?

I am on a small fentanyl pain patch , along with aleve .

Good morning, Mary (and thank you, Colleen, for inviting me to the table). Let me see if I can condense my myelopathy experience:

Going back years––decades––I'd been telling my primary doctors (two, because I had to change insurers) about my "wobbliness," gait difficulties that seemed to be getting worse, inch by inch, over the years. At every turn, my doctors pointed to structural issues as the likely cause of my trouble. (I'd been a long-distance runner, so I knew my joints––at 76––were Super Fund sites of arthritis. In 2008, I received one knee replacement.) I tried changing orthotics (my feet are laughably flat). I've done countless hours of PT. Finally, last fall, I asked my current primary if she would refer me to a neurologist.

The neurologist ordered up some imaging (CTs, MRIs), and in turn, sent me to see a neurosurgeon. (That was last October.) The neurosurgeon diagnosed "borderline" cervical myelopathy. He did not advise revision surgery (not yet). I'll go back to see him next in March. In the meantime, I'm doing lots of heavy-duty cervical PT.

I'm sure you're waiting to hear if I have pain. Or fogginess. No, I don't, neither one. Some of my doctors have had a difficult time believing that. I tell them, though (over and over): No, it's just my wobbly gait. (Luckily I've not fallen, although I've had to teach myself to be a Master of Proprioception.)

It's possible, Mary, that my situation may be so different from yours that my experience with myelopathy will be of limited value. If, though, I can help by answering any questions about issues that appear similar, please just ask. I'll be happy to help in any way I can.

Cheers!
Ray (@ray666)

Yes, I feel like I am drunk , if I stay upright too long. I have a previous ACDF C3 - C5. All was well until 2 years ago. Developed internal vibrations, proximal muscle weakness. Neurosurgeon said wasn’t a spine issue. I have progressed to wobbly gait, fascilations through body, weakness . I am not able to keep my neck upright for more then 3 hours at a time. I feel very woozy and can’t think at this point of time.
I am very fortunate not to have any pain, except muscle straining feeling at base of neck when it’s been up too long.

My spine surgeon just diagnosed me with cervical myelopathy. I also suffer from EDS. I am 74 years old, had spinal surgery a year ago...completely unrelated. The surgeon said that he discovered this in an MRI he ordered last November. (my first question was 'why didn't you mention this sooner!?) My symptoms are getting worse: dizziness and loss of balance, difficulty buttoning, Terrible handwriting (is that normal at this age?!) When I type on text on my phone, I hit two keys at once, or the key next to the one I am trying to tap... it is so frustrating. ABDF surgery will prevent it from getting worse. Then he scheduled me to return to see him in 6 months?!

@ray666
I am 69 and had C5-C6 fusion surgery in March 2026. Since 2020 I complained to various physicians that I had very weak legs, wobbly "drunken" gait and easily lost my balance. No serious falls, no serious pain (intemittent over these years) and was directed to have surgery on my neck related to weakness / numbness in my upper torso.

Only in my first week of PT (focused on my cervical area recovery) and continue to have weak legs, lack of balance, and tire within 20 minutes of walking on my own, with a cane or with a walker.

I am told patience yet they only ask me how my neck and arm / hand numbness feels. I fear that the surgery has done nothing for my walking.

Now I am suffering vertigo in the morning and less so throughout the day. I am not on medication, drink electolyte enriched liquids, but nothing has improved over the past 5-6 days.

Will see what else my physician pool has to offer.

I have cervical myelopathy and am awaiting surgery. I have what i call a “slow brain” since this all started.

Hi, @michc56. The description of your symptoms matches mine to a T: "weak legs, wobbly 'drunken' gait … No serious falls, no serious pain … " When I first started meeting with a neurologist (4-5 years ago?), I was referred to a neurosurgeon to discuss whether cervical surgery might help with my gait. The neurosurgeon and I looked over my imagining, and in the end, he said that, while there was some "borderline encrochment" on my spinal cord, and that, while he could relieve the encrochment, it was highly unlikely that surgery would do anything to help with my gait. I went back a year later for a follow-up, and the neurosurgeon was a little surprised to see that the encrochment, rather than worsening, had actually lessened. I'm not sure, but the lessening might have something to do with neck and cervical spine stretches I do regularly, not for my gait, but to prevent what's sometimes called a "Dowager's hump." While I'm always all-ears for new and/or better approaches to improving my gait, I remain pretty firmly convinced that exercise––in particular leg-strengthening exercise––is my only hope for anything resembling "improvement" in my gait. In the meantime, I'll keep my cane handy! All the best to you, @michc56. 🙂 Cheers! –Ray (@ray666)

@ray666 Thank you for sharing. I started my analysis in 2020, did not have surgery or PT but initiated - walking, stretching, yoga, deep-tissue massage, acupuncture on my own. Things improved significantly, but I still had intermittent loss of balance. Then my legs weakened and I had pain at night in my neck. When seeing a non-invasion physician she directed me to the neurosurgeon for surgery due to the image of my C5-C6. They both addressed the need for surgery "necessary to protect you from paralysis or worse if you fall or are in an accident." I agree with you - serius approach to self-help and manipulations of associated muscles may be better, while it lasts, then surgery, when in my case, I was not in significant pain.

@michc56 I would suggest having your PT check your cervical alignment. You may be having muscle spasms that are shifting the vertebrae above the fusion. This has happened to me before and after my C5 C6 fusion. I have had dizziness and vertigo when my C1 & C2 twist themselves. You PT should be able to realign your vertebrae gently if that is what is causing the symptoms. Vertigo in the morning may be from your neck position on your pillow at night. My PT has me turn my pillow so it's parallel to my body so I can't tuck my chin and cause the vertebrae to slip. That helps a lot.

Have you discussed the vertigo with your PT?