Cervical myelopathy is simply, a problem with the spinal cord in the area of the cervical vertebrae. Myelopathies can be the result of many various problems such as traumas and disc bulges, tumors and even certain diseases. There are many things that can cause myelopathy but often they are caused by the spinal cord being compressed through one means or another. Two main neurons that can be affected are upper and lower motor neurons. Upper motor neurons originate in the brain and end in the spinal cord, whereas lower motor neurons start in the spinal cord and end in muscles. If the cord itself is the problem, upper motor neuron lesions will be seen and can be identified by an increase in muscle tone and muscle spasms. If the nerves coming out of the cord are the area of issue, then lower motor neurons will be affected and cause a decrease in muscle tone and muscle atrophy. Other issues may also arise in various areas or systems of the body depending on where the cord problem is located.
If a cervical myelopathy is caused by compression of the cord by a disc or is of unknown origin, upper cervical chiropractic care may be of great assistance. The upper neck, comprised of the skull, atlas (1st cervical vertebra) and axis (2nd cervical vertebra); is very integral in the health and function of the spinal cord. In this area there are ligaments that come from the atlas and attach DIRECTLY to the spinal cord, called dentate ligaments. This means that if the atlas bone were to shift and become stuck in a misaligned position, those ligaments will stretch and pull on the spinal cord causing distortion. This tension causes spinal cord interference by putting a mechanical traction on the cord as well as closing the small veins in the spinal cord. When the veins are closed in the cord, blood becomes static and there is a lack of nutrients required to perform the high energy task of nerve conduction1. It is because of this that seemingly unknown causes of cervical myelopathy can see results through upper cervical care.
Under normal ranges of motion there is little to no tension on the spinal cord. A 6% strain on the cord, however, was shown to decrease nerve conduction amplitude by 70% after one hour, returning to normal after tension was eased2. The average atlas misalignment on the other hand is 3° and has been seen to create a lateral shift of 3mm which can deform the cord up to 25%3. This highlights the relevance the atlas plays in spinal cord tension and the correction of cervical myelopathies.
Through specialized imaging to analyze the cranio-cervical junction (the skull and top of the neck), it is possible to determine if you have a misaligned atlas contributing to your cervical myelopathy. Even if there may be other factors contributing to your cervical myelopathy, an aligned and properly positioned atlas will facilitate proper cord function and healing.
- Grostic JD. The Origin of the Grostic Procedure. ICA Internat Rev Chiropr, 1978; 32(2):33-5.
- Wall EJ, et al. Experimental Stretch Neuropathy Change in Nerve Conduction Under Tension. J Bone Joint Surg[Br], 1992; 74(1):126-9.
- Eriksen, K., DC. (2020). Neurophysiology and the Upper Cervical Subluxation. Lecture.