Degenerative Cervical Myelopathy

Overview

Degenerative Cervical Myelopathy (DCM) is a progressive condition where age-related changes in the cervical spine (neck) compress the spinal cord. It is the most common cause of spinal cord dysfunction in adults over 50 and can significantly affect mobility, coordination, balance, and quality of life.

At The Royal Buckinghamshire Hospital, we provide consultant-led inpatient neurorehabilitation for individuals recovering from DCM — particularly after surgery or where long-standing compression has affected daily function. Our focus is on improving independence, rebuilding strength and balance, and supporting a return to meaningful activity.

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What Causes Degenerative Cervical Myelopathy?

DCM results from structural changes in the cervical spine that narrow the spinal canal and compress the spinal cord. These changes can include:

• Degenerative disc disease
• Cervical spondylosis (osteoarthritis of the neck)
• Ligament thickening or ossification
• Bone spurs (osteophytes)
• Facet joint degeneration

As the spinal cord is gradually compressed, nerve signals to and from the brain become disrupted, leading to a range of neurological symptoms.

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Common Symptoms

Symptoms often develop slowly but progressively worsen over time:

• Clumsiness or weakness in the hands (e.g. difficulty buttoning shirts, writing)
• Stiffness or heaviness in the legs
• Unsteady or wide-based walking
• Loss of balance, especially on stairs or in the dark
• Neck pain or stiffness
• Electric-shock sensations down the spine with neck movement (Lhermitte’s sign)
• Urinary urgency or hesitancy
• Pins and needles, numbness or altered sensation in arms or hands

DCM can sometimes be mistaken for arthritis, stroke or carpal tunnel syndrome, leading to delays in diagnosis.

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Diagnosis

Diagnosis is based on a combination of clinical assessment and imaging:

• Neurological examination — reflexes, strength, sensation, balance and coordination
• MRI of the cervical spine — to identify compression, disc degeneration, or spinal canal narrowing
• Electrophysiological testing — occasionally used to assess nerve conduction

At The Royal Buckinghamshire Hospital, we support patients after diagnosis has been confirmed and surgical or non-surgical treatment is underway or completed.

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Rehabilitation At The Royal Buckinghamshire Hospital

We offer a comprehensive inpatient programme for adults with cervical myelopathy, including post-operative cases and those with ongoing disability from delayed treatment.

Consultant-Led Care

Patients are under the supervision of a consultant in rehabilitation medicine, supported by a full multidisciplinary team.

Physiotherapy

• Postural and spinal mobility exercises
• Gait training and balance work
• Strength and endurance reconditioning
• Spasticity management if needed
• Vestibular and proprioceptive input

Occupational Therapy

• Upper limb function retraining
• Self-care and daily living adaptations
• Equipment assessment and hand therapy
• Sensory re-education strategies

Nursing Care

• 24/7 specialist neuro-nursing
• Support for continence management
• Skin care, medication administration and nutritional support

Additional Services

• Neuropsychology for mood, cognition and adjustment
• Dietetics for energy, muscle health and bone strength
• Speech and language therapy if voice, swallowing or communication are affected
• Access to a Discharge Coordinator for home planning

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When To Enquire Or Refer

We accept adult patients (18+) with:

• Confirmed DCM (pre- or post-surgery)
• Functional disability requiring inpatient therapy
• Recovery from delayed diagnosis or long-term compression
• Medically stable and safe to engage in intensive rehabilitation

Call 01296 678800 or enquire online for referral information or to discuss suitability and availability.

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Why Choose The Royal Buckinghamshire Hospital?

• Expertise in complex and rare spinal cord conditions
• Intensive inpatient therapy tailored to spinal cord injury recovery
• Access to rehabilitation 5–7 days per week
• Consultant-led care with full multidisciplinary support
• Calm, private environment with ensuite rooms and chef-prepared meals