Cervical Myelopathy Life Expectancy

Short answer: research suggests that, on average, people with cervical myelopathy have a somewhat shorter life expectancy than people of the same age without it. In a long-term UK study, people who had surgery for degenerative cervical myelopathy had about an 18% higher risk of death over 15 years than the general population. The extra risk was concentrated in people left with severe disability, which is why diagnosis and treatment before the spinal cord is badly damaged matter so much.

What is cervical myelopathy?

Cervical myelopathy means the spinal cord in the neck is being compressed. The most common form is degenerative cervical myelopathy (DCM), also called cervical spondylotic myelopathy, where age-related changes in the neck narrow the spinal canal. These changes include worn and bulging discs, bone spurs and thickened or hardened ligaments. It is more common after the age of 50. Other causes include a spinal canal that is narrow from birth, rheumatoid arthritis of the neck, neck injuries, and, rarely, infections or tumours.

Typical symptoms are:

• clumsy hands and difficulty with small tasks such as writing or doing up buttons
• numbness, tingling or weakness in the arms, hands or legs
• heavy or stiff legs, unsteady walking and tripping
• neck pain or stiffness (not everyone has this)
• in more serious cases, problems with bladder or bowel control

How common is it, and how often is it missed?

A 2022 UK modelling study estimated that about 0.19% of adults are diagnosed with DCM in hospital records, but that around 2.2% of adults may have spinal cord compression consistent with it, rising to about 4.2% in people over 79. The authors concluded that most DCM remains undiagnosed, especially in older people, whose symptoms are easily put down to normal ageing.

What does the research say about life expectancy?

The main long-term evidence comes from a study published in 2023 by researchers at the University of Cambridge. They followed 357 adults who had surgery for DCM in England between the mid-1990s and 2007, for a median of 15 years, and compared their survival with people of the same age and sex in the general population.

Among people who were still alive two years after surgery, only severe disease was still linked to shorter survival. The authors concluded that life expectancy is reduced after surgery for DCM, and that this is "driven by premature mortality among those left with severe disability". They suggest that treating people earlier, before severe disability sets in, could restore normal life expectancy, but this study didn't test that directly.

What the study can't tell us

• It only included people who had surgery, so it says nothing about people who weren't operated on.
• Patients were treated before 2007, so it doesn't reflect current treatment.
• Causes of death weren't recorded, so it can't say exactly how myelopathy shortens life.
• The comparison group was matched only by age and sex, not by other health conditions.

What affects the outlook?

From the research above, the two factors most clearly linked to survival were:

• How severe the myelopathy is. People with severe disability had the highest risk.
• Age at the time of surgery.

Physiotherapy, pain relief or a neck collar can ease symptoms but don't remove the pressure on the spinal cord, so surgery is often needed to take the pressure off and stop the condition getting worse. The usual aim of surgery is to stop symptoms getting worse, rather than to guarantee improvement. That is why earlier diagnosis is expected to lead to more successful treatment.

When to get help

• See your doctor if you notice your hands getting clumsier, numbness or tingling in your hands, or changes in your walking or balance. Don't assume it is just ageing.
• If you already have a diagnosis, contact your doctor or spinal team promptly if your hands are getting weaker or clumsier, or your walking is getting worse.
• Go to an emergency department straight away if you develop new problems with your bladder or bowels, or new numbness or tingling around your genitals or bottom.

Summary

On average, people with cervical myelopathy, particularly those left with severe disability, have a somewhat shorter life expectancy than people of the same age without it. Recognising the symptoms early and getting specialist assessment gives the best chance of stopping it before the spinal cord is badly damaged.