Duke's experts offer advanced surgical options to treat compression of the spinal cord, referred to as myelopathy. It is most common in the neck (cervical myelopathy) and middle back (thoracic myelopathy). Our experts treat myelopathy as well as contributing spine conditions, like spinal stenosis, disc herniations, spine injuries, spine cancer, and others. Myelopathy progressively worsens without treatment, so it’s important to seek care right away. Once we understand your problems and goals, we can create a treatment plan that is tailor-made for you.
Duke Health offers locations throughout the Triangle. Find one near you.
Tests for Myelopathy
X-rays take pictures of bones and joints in your back. They can help identify fractures, tumors, dislocations, bone spurs, instability, or other potential causes of symptoms. This test takes about 15 minutes and is virtually painless. Because X-rays only show bones, and not discs or nerves, an additional imaging test may also be needed.
Magnets and radio waves create detailed pictures of your spine, including your discs, nerves, and spinal cord. Images can help identify disc damage, pinched nerves, or spinal cord compression. This test takes about 30 to 60 minutes and is virtually painless.
Computed Tomography (CT)
A series of cross-sectional pictures produce detailed, 3D images of your spine. This test takes about 30 to 60 minutes and is virtually painless.
A dye is injected into the sac around the nerve roots in your spinal cord to make them more visible on a CT scan. This test is often used for people who are unable to get an MRI. You will feel some discomfort during the injection. This test takes about one or two hours.
Electromyogram (EMG) / Nerve Conduction Study (NCS)
Electrodes are inserted directly into muscle with a thin needle to record electrical activity. You will feel some discomfort. EMG and NCS, which can last from 30 to 90 minutes, measure how well muscles and nerve cells are working in a certain area of your body -- in this case, your back or neck.
Why Choose Duke
Highly Experienced Spine Center
Research shows that hospitals and surgeons who perform more surgeries tend to have better outcomes. Our surgical team performs more than 3,000 spine surgeries every year and sees over 40,000 patients.
Surgery for myelopathy can be very challenging because it involves such a tiny, delicate area. These surgeries are commonly done using a surgical microscope and involve removing bone spurs, disc material, and scar tissue surrounding the nerve roots or spinal cord. Choosing highly specialized spine surgeons with advanced training, experience, and skill means you may have better, safer outcomes.
Minimally Invasive Spine Surgeries
Whenever possible, we use advanced minimally invasive procedures. Using high-powered microscopes and tiny instruments, surgeons can access the spine through small incisions. This technique limits muscle damage, results in less pain, and helps you recover faster.
Operating Room Technology
Our ORs are equipped with real-time imaging options that give spine surgeons detailed, 3D pictures and video of your spine. These systems help decrease the need for extra imaging after surgery, exposing you to less radiation. OR staff also use a sophisticated sensor navigation system that helps them avoid vital nerves and other structures. This allows for more surgical accuracy than ever before.
Team of Specialists
In addition to neurosurgeons and orthopaedic surgeons, your team may include physiatrists (physical medicine and rehabilitation doctors who specialize in conservative spine care), physical therapists, psychologists, pain management experts, and others -- all of whom work with you to alleviate the symptoms caused by your myelopathy.
Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our orthopaedics, neurology, and neurosurgery programs are nationally ranked, and are the highest ranked programs in North Carolina, according to U.S. News & World Report for 2021–2022.