Your doctor can diagnosis cervical spondylitic myelopathy after reviewing your medical history, conducting an examination, and considering the results of medical imaging tests. You should tell your doctor about your symptoms, risk factors, and functional problems, such as difficulty getting dressed, feeding yourself, or walking. Your doctor may check your muscle reflexes, tone, strength, coordination, and range of motion. Your balance and gait pattern will be assessed. Your sense of touch and temperature will be tested.
Your doctor may order X-rays to see the condition of the vertebrae in your cervical spine.
Sometimes doctors inject dye into the spinal column to enhance the X-ray images in a procedure called a myelogram. A myelogram can indicate if there is pressure on your spinal cord or nerves from herniated discs, bone spurs, or tumors.
Your doctor may order computed tomography (CT) scans or magnetic resonance imaging (MRI) scans to get a better view of your spinal structures. CT scans provide a view in layers, like the slices that make up a loaf of bread. The CT scan shows the shape and size of your spinal canal and the structures in and around it. The MRI scan is very sensitive. It provides the most detailed images of the discs, ligaments, spinal cord, nerve roots, or tumors. X-rays, myelograms, CT scans, and MRI scans are painless procedures.
In some cases, doctors use nerve conduction studies to measure how well the cervical spinal nerves work and to help specify the site of compression. Doctors commonly use a test called a nerve conduction velocity (NCV) test. During the study, a nerve is stimulated in one place and the amount of time it takes for the message or impulse to travel to a second place is measured.
Somatosensory evoked potentials (SSEPs) or motor evoked potentials (MEPs) are used to test how the spinal cord transmits nerve signals about sensory or movement information. Your doctor will place sticky patch-like electrodes on your skin that covers a spinal nerve. The NCV test may feel uncomfortable while it is performed.
An electromyography (EMG) test is often done at the same time as the NCV test. An EMG measures the impulses in the muscles to identify damage or decay. Muscles need impulses to perform movements. Your doctor will place fine needles through your skin and into the muscles that the spinal nerve controls. Your doctor will be able to determine the presence of muscle damage, as well as the quality of the nerve impulses conducted when you contract your muscles. The EMG may be uncomfortable, and your muscles may remain a bit sore following the test.