⚠️ Cervical myelopathy is progressive — Early treatment prevents permanent spinal cord damage
Cervical Spine Surgery · Hyderabad
Cervical Myelopathy Decompression Surgery in Hyderabad
Dr. Sayuj Krishnan specializes in endoscopic and minimally invasive surgical decompression for cervical myelopathy (spinal cord compression). Early intervention prevents permanent neurological damage and restores quality of life.
⚠️ When to Seek Neurosurgical Help for Neck & Hand Problems
See a spine surgeon promptly if you experience any of these progressive symptoms:
Hand Clumsiness
Difficulty buttoning shirts, writing, using chopsticks, or dropping objects
Gait Problems
Unsteady walking, frequent trips, difficulty climbing stairs
Progressive Weakness
Weakness in arms and legs that gets worse over weeks/months
Numbness
Numbness in hands and feet, "like wearing gloves or socks"
Bowel/Bladder Changes
Urgency, hesitancy, or loss of control (seek URGENT care)
Electric Shocks
Shock-like sensation down spine when bending neck (Lhermitte's sign)
⏰ DON'T WAIT: Cervical myelopathy is progressive. Delaying treatment can lead to permanent spinal cord damage. If you have hand clumsiness + gait problems, see a neurosurgeon within 1-2 weeks.
Understanding Cervical Myelopathy
Cervical myelopathy occurs when the spinal cord in the neck becomes compressed, typically due to degenerative changes like disc herniation, bone spurs (osteophytes), or thickened ligaments. Unlike radiculopathy (pinched nerve causing arm pain), myelopathy affects the spinal cord itself, causing problems with hand function, balance, and coordination.
This is a progressive condition that does not improve on its own. Without surgical decompression, patients gradually lose hand dexterity, develop gait instability, and may eventually become wheelchair-dependent. The spinal cord has limited ability to recover once severely damaged, making early diagnosis and treatment critical.
Most patients over 50 have some degree of cervical stenosis on MRI, but not all develop myelopathy. We correlate your MRI findings with clinical examination to determine if surgery is warranted.
Clinical Evaluation Process
- Detailed neurological exam assessing hand coordination, gait, reflexes, and sensory function
- MRI cervical spine to visualize cord compression and signal changes
- Assessment of myelopathy severity using mJOA score
- Discussion of conservative vs. surgical management
- Preoperative planning and risk assessment
- Multidisciplinary approach with physiotherapy and rehabilitation
Surgical Treatment Options
Anterior Cervical Discectomy & Fusion (ACDF)
Gold-standard procedure for 1-3 level cervical myelopathy caused by disc herniations and anterior compression. Through a small neck incision, we remove the diseased disc, decompress the spinal cord, and stabilize with a cage and plate. Most patients go home in 24-48 hours.
- • Best for anterior cord compression
- • High fusion rates (95%+)
- • Immediate stability
- • Proven long-term outcomes
Posterior Cervical Laminoplasty
Motion-preserving procedure ideal for multi-level stenosis and ossification of posterior longitudinal ligament (OPLL). The lamina is hinged open like a door to expand the spinal canal while preserving neck range of motion. Suitable for patients with preserved cervical lordosis.
- • Preserves neck motion
- • Treats multi-level disease
- • Lower adjacent segment disease risk
- • Popular in Asia for OPLL
Endoscopic Cervical Decompression
Minimally invasive endoscopic approach for selected cases of posterior compression. Using tubular retractors and HD endoscope, we decompress the spinal cord while preserving paraspinal muscles. This reduces postoperative neck pain and allows faster rehabilitation.
- • Muscle-preserving technique
- • Reduced blood loss
- • Faster recovery
- • Outpatient or 1-night stay
Cervical Laminectomy with Fusion
For severe multi-level stenosis with loss of cervical curve (kyphosis), we perform laminectomy (removing the back part of vertebrae) combined with instrumented fusion using screws and rods. This provides durable decompression and prevents post-laminectomy kyphosis.
Recovery Timeline & Rehabilitation
Day 0-1
Walking within hours of surgery. Pain control with oral medications. Collar fitted for anterior procedures.
Week 1-2
Gradual return to light activities. Wound check and X-rays. Start physiotherapy for neck strengthening.
Week 4-6
Collar removed after fusion procedures. Return to desk work. Driving permitted. Progressive increase in activity.
Month 3-6
Continued neurological recovery. Hand function and gait continue to improve. Fusion confirmed on X-ray/CT.
Frequently Asked Questions
What are early warning signs of cervical myelopathy?
Early symptoms include hand clumsiness (dropping cups, difficulty with buttons or writing), gait unsteadiness, frequent trips or falls, and subtle numbness in hands and feet. Many patients also notice stiffness in legs and difficulty going up stairs. These symptoms are progressive and worsen without treatment.
Can cervical myelopathy be reversed with surgery?
Surgery stops progression and often improves function, particularly when performed early. Mild to moderate myelopathy can show significant recovery. However, severe longstanding cord compression may have caused irreversible damage. The key is not to delay — early decompression offers the best outcomes.
What is endoscopic cervical decompression?
Endoscopic cervical decompression uses minimally invasive techniques with HD endoscope to remove bone and disc compressing the spinal cord. The posterior muscles remain intact, reducing postoperative pain and allowing faster return to activities. This is ideal for single or two-level disease.
How long is recovery after cervical myelopathy surgery?
Most patients are walking the same day and discharged in 2-4 days. Neck collar is worn for 4-6 weeks. Desk work resumes in 2-3 weeks; driving after collar is removed. Neurological recovery continues over 3-6 months with physiotherapy support.
When should I seek urgent care for myelopathy symptoms?
Seek immediate neurosurgical consultation if you develop sudden weakness in arms or legs, loss of hand function, difficulty walking, or bowel/bladder problems. Rapid progression of myelopathy symptoms requires urgent imaging and surgical planning.
Dr. Sayuj Krishnan, Neurosurgeon
Room 317, OPD Block, Yashoda Hospital, Malakpet, Hyderabad, Telangana 500036
Phone: +91 9778280044 · Email: hellodr@drsayuj.info
Authored by: Dr. Sayuj Krishnan S, Neurosurgeon
Reviewed by: Dr. Sayuj Krishnan S, Board Certified Neurosurgeon
Last reviewed: 1 November 2025
Disclaimer: This content is for informational purposes only and should not replace professional medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment.
Medically reviewed by Dr. Sayuj KrishnanConsultant Neurosurgeon, Yashoda Hospital MalakpetLast reviewed 19 October 2025
This information is for educational purposes only and should not replace professional medical advice. Please consult with Dr. Sayuj for personalized medical guidance.