Cervical Myelopathy: Symptoms and Surgery in Istanbul

In short

What Is Cervical Myelopathy?

Cervical myelopathy means pressure on the spinal cord in the neck that disturbs its signals. As a result, the hands turn clumsy, walking grows unsteady, and the damage can last. Most often, age-related wear narrows the spinal canal slowly over many years.

Doctors also call it degenerative cervical myelopathy (DCM) or cervical spondylotic myelopathy. It rarely improves on its own, so timing matters.

At a Glance

What it isPressure on the spinal cord in the neck
Early signsClumsy hands, trouble with buttons and an unsteady walk
Usual causeAge-related wear that narrows the spinal canal
DiagnosisA neurological examination and an MRI of the neck
Main treatmentDecompression surgery from the front or the back of the neck
Flying homeAfter a check-up; UK guidance sets no fixed time after spine surgery

However, sharp pain shooting down one arm usually comes from a pinched nerve root. For that, see our guide to cervical disc herniation.

Start with your situation

Which Symptom Brought You Here?

First, pick the line that fits you best. Each one then leads to the matching part of this guide.

01Clumsy hands or dropping thingsTrouble with buttons, handwriting or keys
02Unsteady walking or stiff legsPoor balance, stumbles and trouble in the dark
03Electric shocks when you bend your neckOften with numbness in both hands
04Sudden weakness or loss of bladder controlSigns that need care the same day
05An MRI shows pressure on the cordWhen close follow-up suits you, and when surgery does
06Planning surgery from abroadStay, flights and follow-up at home

Symptoms

Cervical Myelopathy Symptoms

Symptoms usually creep in over months, so many people blame age or tiredness. Neck pain, in fact, may be mild or absent. Instead, the first clear signs often show up in the hands.

Clumsy hands and a weaker grip

Fine hand skills often suffer first. For example, buttons, handwriting, keys and coins all get harder. Cups and pens may also slip from the fingers.

Numbness usually affects both hands, and the small hand muscles can weaken too.

Unsteady walking and stiff legs

The cord in the neck also carries signals to the legs. So walking feels stiff or wobbly, and steps grow wider. Stairs and walking in the dark then become harder.

Stumbles and falls can then follow. With a narrow canal, however, even a small fall can harm the cord.

Electric shocks, numbness and bladder changes

Some people feel an electric shock down the back when they bend the neck forward. Doctors call this Lhermitte's sign, and it points to the spinal cord.

Numbness can also spread to the trunk or legs. Later, bladder control may change too, with urgency, frequent trips or leaks.

Myelopathy or Radiculopathy?

Radiculopathy means pressure on a single nerve root, so sharp pain runs down one arm. Myelopathy, in contrast, affects the cord itself: both hands, the legs and balance. Arm pain often settles without surgery, but myelopathy tends to worsen.

Questions at this stage

Can cervical myelopathy cause leg weakness?

Yes, because the cord in the neck also serves the legs. They can feel heavy, stiff or weak. Many people first notice poor balance.

Do cervical myelopathy symptoms come and go?

They can seem to, since good and bad days alternate. Overall, however, myelopathy tends to worsen slowly. So a calm spell does not mean the pressure has gone.

Act early

When to See a Doctor About Myelopathy Symptoms

Hand or walking problems that slowly worsen need a doctor's visit soon. Sudden changes, however, need emergency care the same day.

Book a doctor's visit soon if you notice:

Clumsy hands, or trouble with buttons or handwriting
Numbness in both hands that slowly spreads
A stiff, unsteady walk or new stumbles
Electric shocks down the back when you bend your neck

Seek emergency care the same day for:

New problems walking
Loss of bladder or bowel control
Sudden clumsiness, such as trouble buttoning a shirt
Weakness in the arms or legs that grows within days
New numbness or weakness after a fall or neck injury

The NHS lists the first three as reasons to call 999 in the UK. In the US and Canada, call 911; in the EU, call 112.

Causes

What Causes Cervical Myelopathy?

Most cases come from age-related wear that narrows the spinal canal step by step. Usually, several changes add up over years:

Flatter discs that bulge backward
Bone spurs (osteophytes) that grow into the canal
A thicker ligament at the back of the canal
Larger facet joints that narrow it from the sides
A small slip between two vertebrae

Smoking, heavy lifting and long hours with a bent neck can also speed it up.

OPLL, a Narrow Canal and Rarer Causes

In OPLL, a ligament inside the spinal canal slowly turns to bone. The name stands for ossification of the posterior longitudinal ligament. It often narrows the canal over several levels, and CT shows it best.

Some people also have a narrow canal from birth. Then even a small disc bulge or a minor injury can press on the cord.

Rarer causes include a large disc herniation, rheumatoid arthritis in the upper neck and infection. A spinal cord or spine tumor can cause similar signs too.

Is cervical myelopathy hereditary?

Not directly. However, the width of the spinal canal varies between people and can run in families. A canal that is narrow from birth also makes symptoms start earlier.

Diagnosis

How Doctors Diagnose Cervical Myelopathy

Diagnosis rests on two pillars: a neurological examination and an MRI of the neck. Neither one is enough alone, since many people show narrowing on MRI without any symptoms.

What the Examination Looks For

First, the surgeon tests strength, feeling, reflexes and balance, and watches you walk. Some quick, painless signs also point to the cord:

Hoffmann sign: the thumb bends when the doctor flicks a fingernail
Babinski sign: the big toe lifts when the doctor strokes the sole
Clonus: the ankle keeps beating after a quick stretch
Brisk reflexes at the knees and elbows
Grip and release test: how fast your hands open and close
Romberg test: balance with your feet together and eyes closed

Scans and Other Tests

Test	What it shows	When it helps
MRI of the neck	Pressure on the cord, and any swelling or bright signal inside it	For everyone; the key test
CT scan	Bone spurs and OPLL in fine detail	Planning surgery
X-rays, standing and bending	The curve of the neck, and any slip with movement	Choosing the approach and checking stability
EMG and nerve tests	How well nerves and muscles carry signals	Ruling out carpal tunnel syndrome or ALS
Brain MRI and blood tests	MS, hydrocephalus or low vitamin B12	When another cause seems possible

Grading Severity: the mJOA Score

Surgeons also grade severity with the mJOA score, from 0 to 18. Scores of 15-17 count as mild, 12-14 as moderate and 11 or below as severe. So a lower score, or a falling one, makes surgery more likely.

Does cervical myelopathy show up on an MRI?

Yes. MRI shows the narrow canal, the pressure on the cord and any change inside it. Narrowing without symptoms, however, is common, so the examination decides what the scan means.

Look-alike conditions

Conditions That Can Look Like Cervical Myelopathy

Myelopathy symptoms are not specific, so other conditions can mimic them. A careful check therefore rules these out before any decision.

Condition	What looks similar	What tells it apart
Carpal tunnel syndrome	Numb, clumsy hands	No leg or balance problems; nerve tests point to the wrist
Multiple sclerosis (MS)	Poor balance, weakness, Lhermitte's sign	Typical patches on a brain MRI
ALS (motor neuron disease)	Weakness with brisk reflexes	No loss of feeling; muscle twitching
Peripheral neuropathy (often from diabetes)	Numb hands and feet	Weaker reflexes, not brisker ones
Vitamin B12 deficiency	Poor balance and numbness	A blood test shows it
Normal pressure hydrocephalus	Unsteady walking, bladder problems	Memory changes; large fluid spaces on a brain scan
Lumbar spinal stenosis	Shorter walking distance	No hand symptoms; sitting brings relief
Syringomyelia	Weak, wasting hands	Lost feeling for hot and cold; a fluid cavity in the cord

Neck and Lower Back Together

Sometimes the canal narrows in the neck and the lower back at the same time. Doctors call this tandem stenosis. Prof. Albayrak then usually treats the neck first, since cord pressure carries more risk.

Can cervical myelopathy cause dizziness?

It can cause unsteadiness, which some people describe as dizziness. A spinning feeling (vertigo), however, usually has another cause, such as an inner ear problem. So describe exactly what you feel at your visit.

Decide with confidence

Does Cervical Myelopathy Always Need Surgery?

Not always. For example, mild myelopathy that stays stable can do well with close follow-up. Moderate or worsening myelopathy, however, usually calls for surgery to stop further damage.

Close follow-up may suit you if:

Your symptoms stay mild and steady for months
Your MRI shows no bright signal inside the cord
Your mJOA score stays in the mild range
Other illnesses make anesthesia unusually risky

Surgery is worth discussing if:

Your myelopathy is moderate or severe (mJOA 14 or lower)
Hand skills or walking keep getting worse
The MRI shows swelling or a bright signal in the cord
The cord looks flat at several levels, or the neck moves too much

During follow-up, Prof. Albayrak usually examines you every 6 months and repeats the MRI yearly. Meanwhile, avoid neck manipulation and forceful stretching. If anything new appears, he then reviews the plan straight away.

Why Timing Matters

Surgery aims to stop the damage, not to reverse all of it. As the NHS puts it, surgery is not always a cure. Even so, it may stop symptoms from getting worse.

US NIH guidance also notes that badly damaged nerves may not fully recover. So surgeons often advise surgery before severe damage sets in. A shorter history of symptoms also tends to mean more recovery.

Can cervical myelopathy be reversed?

Partly, in some people. After surgery, many regain some hand skill or balance. Long-standing damage, however, may not recover.

Can physical therapy alone treat cervical myelopathy?

No. Physical therapy (physiotherapy) cannot remove the pressure on the cord. It can, however, help mild cases keep strength and balance. After surgery, it also plays a key role in recovery.

Surgery

Cervical Myelopathy Surgery: Front or Back of the Neck?

Decompression surgery removes what presses on the cord, such as disc, bone spurs or ligament. A fusion then steadies the neck if needed. Surgery works from the front, the back or both.

Prof. Albayrak therefore chooses the route for each patient. He weighs where the pressure lies, how many levels it spans and the neck's curve.

Front of the Neck: ACDF and Corpectomy

ACDF stands for anterior cervical discectomy and fusion. It removes the problem discs through a small cut in the front of the neck. A cage then fills each space, and the vertebrae fuse over the following months.

Corpectomy goes further and removes part of a vertebral body too. A cage or bone strut, usually with a plate, then bridges the gap.

Back of the Neck: Laminoplasty and Laminectomy

Laminoplasty opens the back of several vertebrae like a door on a hinge. Small plates then hold the door open, so the canal stays wider. As a result, the neck usually keeps more movement than after a fusion.

Laminectomy, in contrast, removes the back of the vertebrae (the lamina). Screws and rods then usually fuse those levels, which also steadies the neck.

Why the Curve of the Neck Matters

A healthy neck has a gentle inward curve (lordosis). If it bends forward instead (kyphosis), the cord drapes over bone in front. Then back surgery alone may not relieve it, so the front route usually suits better.

Myelopathy Operations Compared

Operation	Approach	Best suited for	Main trade-off
ACDF	Front	Discs or bone spurs at one or two levels	Fused levels stop moving
Corpectomy and fusion	Front	Pressure behind the vertebral bodies, or a forward-bent neck	Longer surgery; more swallowing trouble at first
Cervical disc replacement	Front	Selected younger patients, at one level	Keeps movement, but suits few people
Laminoplasty	Back	Several levels, including OPLL, with a normal curve	Neck pain and stiffness at first
Laminectomy and fusion	Back	Several levels in a neck that slips or moves too much	Fused levels stop moving; more muscle pain at first
Combined surgery	Front and back	Severe deformity	The most extensive option

Is laminoplasty better than laminectomy and fusion?

Neither suits everyone. Laminoplasty keeps more movement, while a fusion also steadies a neck that slips. So the curve and stability of your neck decide.

Risks

What Are the Risks of Cervical Myelopathy Surgery?

Serious complications are uncommon, but every operation near the spinal cord carries risk. The risks also differ between front and back surgery.

After Surgery from the Front

Sore throat and trouble swallowing for days to weeks
A hoarse voice that usually recovers
Rarely, neck swelling that affects breathing and needs urgent care

After Surgery from the Back

Neck pain and stiffness while the wound heals
Weakness lifting the arm at the shoulder (C5 palsy), which often improves
Wound problems, a little more often than after front surgery

Risks of Any Spine Operation

Infection or a spinal fluid leak
New weakness from injury to the cord or a nerve root
A fusion that does not heal, or loose screws
Blood clots in the legs or lungs
Faster wear at levels next to a fusion

Smoking slows bone healing, so stopping before surgery helps the fusion.

Is cervical myelopathy surgery dangerous?

It carries real risks, like any operation near the spinal cord. Serious complications, however, are uncommon, and doing nothing carries risks too. So weigh both sides with your surgeon.

Recovery

Recovery After Cervical Myelopathy Surgery

Most people stand up with help on day one and go home within a week. Nerve recovery, however, takes months, and it can continue for up to two years.

A Typical Recovery Timeline

When	What usually happens	What to watch
Days 1-3	Standing and short walks with help	Sore throat after front surgery
Week 1	Discharge from hospital	No heavy lifting or sudden neck turns
Weeks 2-6	Back to daily activities, step by step	A collar only if your surgeon advises one
Weeks 6-12	More intensive physical therapy	Balance, walking and hand skills
Months 3-6	The fusion turns solid	Check-up X-rays
Months 6-24	Nerve recovery continues	Slow but lasting gains

Getting Back to Daily Life

Hand skills often recover last, so slow progress in the first weeks is normal. Physical therapy then works on balance, safe walking and fine finger movements.

US guidance after spine surgery advises only short walks for the first 2 weeks. It also advises against lifting more than about 4.5 kg (10 lb) at first.

How long does it take to recover from cervical myelopathy surgery?

First, most people return to light daily activities within 2-6 weeks. A fusion takes about 3-6 months to turn solid. Nerve recovery, however, can continue for one to two years.

International patients

Coming to Istanbul from the US, Canada, the UK or Europe

Plan the trip around three parts: the hospital stay, rest nearby and a final check-up. Then add a few days for the consultation and tests.

How Long to Stay in Istanbul

Most people leave hospital within a few days and then rest at a nearby hotel. Overall, many patients plan about two weeks in Istanbul, with a flexible return date.

When You Can Fly Home

UK aviation guidance (CAA) sets no fixed wait after spine surgery. Its 7-day advice applies to brain surgery. So your surgeon decides, after checking the wound, your walking and your clot risk.

The US CDC also warns that flying after surgery raises the risk of blood clots. It suggests waiting 10-14 days after major surgery, especially chest surgery.

Book an aisle seat, drink water and move your ankles often
If walking already feels unsteady, ask the airline for help at both airports

Follow-Up at Home

First, ask for your discharge summary, operation note and scan copies before you leave. Then book visits with your local doctor and a physical therapist.

UK drivers must tell the DVLA about a spinal condition that affects driving. After spinal surgery, GOV.UK also advises checking with your doctor before you drive again.

For insurance and Medicare, see brain surgery in Turkey: planning from the US. For NHS rules and travel insurance, see planning from the UK. From Canada, check with your provincial health plan and private insurer before you book.

Your treatment in Istanbul

Your Myelopathy Treatment in Istanbul, Step by Step

The visit follows four steps, from your first message to the flight home. Each step then answers one practical question.

01 Request
02 Consultation
03 Surgery
04 Recovery

STEP 01

Request an appointment

Use the form on this page, WhatsApp or call +90 532 308 97 72. A short message is enough: your symptoms, your country and your travel dates.

You can write in English or Turkish. The team then arranges the consultation date with you.

STEP 02

Consultation and tests in Istanbul

Prof. Albayrak examines you at his clinic in Terrace Fulya Center, Teşvikiye, Şişli. He checks your hands, walking, reflexes and balance, then goes through your MRI with you.

If your scans are old, you can also have new ones in Istanbul. He then explains which option suits you, and why.

Questions worth asking at the consultation:

How severe is my myelopathy, and what is my mJOA score?
Does my MRI show a change inside the cord?
What can I expect after surgery, and what if I wait?

What should I bring to my myelopathy consultation?

Bring your scans on a disc or USB drive, with the written reports. Also bring a list of your medicines and notes on how your symptoms changed.

STEP 03

Surgery and hospital stay

If you choose surgery, it takes place in a hospital in Istanbul, under general anesthesia. Prof. Albayrak names the hospital at the consultation, along with the likely stay.

During the operation, nerve monitoring tracks signals along the cord. It then warns the team at once if they change.

STEP 04

Recovery, fitness to fly and follow-up

After discharge, you rest at a nearby hotel, ideally with a companion. Then, before the flight, your surgeon checks the wound and your walking.

Back home, get urgent help for any of these signs:

Trouble breathing, or fast swelling in the neck
Fever, or redness or discharge at the wound
New weakness or numbness in the arms or legs
Calf pain or swelling, chest pain or shortness of breath

Your surgeon

Your Myelopathy Surgeon in Istanbul

Prof. Dr. Serdar Baki Albayrak

Neurosurgeon · Full Professor of Neurosurgery

Prof. Albayrak decompresses the spinal cord from the front or the back of the neck. Nerve monitoring and the operating microscope also guide him throughout.

He completed his neurosurgery training at Istanbul University in 2004. He then took clinical fellowships at the University of Helsinki and Harvard Medical School.

At Harvard, he trained at Brigham and Women's Hospital. Consultations take place in English or Turkish.

27+Years

5,000+Operations

64Countries

33Publications

Figures from Prof. Albayrak's professional profile, September 2026. See his full publication list.

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FAQ

Frequently Asked Questions

Is cervical myelopathy serious?

It can be, because a spinal cord under pressure may not fully recover. Many people, however, stay stable for long periods with close follow-up. Early diagnosis and regular checks therefore matter most.

How much does cervical myelopathy surgery cost in Turkey?

The cost depends on the approach, the number of levels and the implants. Nights in hospital, new scans and your hotel stay also count. So ask for the cost of your own plan at the consultation, before you decide.

Can cervical myelopathy come back after surgery?

The treated levels usually stay open. Wear can continue at other levels, however, especially next to a fusion. So report any new hand or walking problem at follow-up.

Prof. Albayrak's Published Research

No paper by Prof. Albayrak, among his 33 publications, studies cervical myelopathy itself. Two experimental studies examine cord injury from compression and scarring after laminectomy. Two clinical reports also describe a tumor and an abscess inside the spinal canal.

The effects of medroxy progesterone acetate on the pro-inflammatory cytokines, TNF-alpha and IL-1beta in the early phase of the spinal cord injuryNeurological Research, 2011 · Co-author
Topical application of tacrolimus prevents epidural fibrosis in a rat postlaminectomy model: histopathological and ultrastructural analysisTurkish Neurosurgery, 2011 · Co-author
Cervical leptomeningeal and intramedullary metastasis of a cerebral PNET in an adultJournal of Neuro-Oncology, 2005 · Co-author
Spinal epidural abscess due to BrucellaSurgical Neurology, 2006 · Co-author

Public health information

NHS. Cervical spondylosis.
MedlinePlus, US National Library of Medicine. Cervical spondylosis.
MedlinePlus. Spinal stenosis.
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Spinal stenosis.
NIAMS. Spinal stenosis: diagnosis, treatment and steps to take.
MedlinePlus. Spinal fusion.
MedlinePlus. Spine surgery - discharge.
UK Civil Aviation Authority. Surgical conditions: guidance for health professionals.
US Centers for Disease Control and Prevention. Medical tourism.
GOV.UK, Driver and Vehicle Licensing Agency. Spinal conditions, injuries or spinal surgery and driving.

This page gives general medical information and does not replace a consultation. Diagnosis and treatment decisions need an examination by your own doctor.

Last updated: 1 October 2026. Website editor: Prof. Dr. Serdar Baki Albayrak's clinic, [email protected].

Plan Your Myelopathy Consultation in Istanbul

Request an appointment with Prof. Dr. Serdar Baki Albayrak. The team then helps you plan the dates of your visit.