The Neck Bending Over Smartphones... Warning for 'Gyeongchu Cheoksujeung' [Taking Care of Health for the MZ Generation]

"Neglecting it can lead to paralysis
Early diagnosis and treatment tailored to the cause are crucial"

[Asia Economy Reporter Kim Young-won] Modern people check their smartphones dozens of times a day. Especially, the younger generation tends to use smartphones for relatively longer periods. According to Statistics Korea, the age group with the longest smartphone usage time is 15-19 years old (3.6 hours), followed by those in their 20s at 2.5 hours. When using smartphones, people habitually lower their heads, and this incorrect posture can harm neck health. Various diseases can occur in the cervical spine, including herniated discs, but the most dangerous among them is 'cervical myelopathy.' This is because it can potentially lead to paralysis of the limbs.

Cervical myelopathy is myelopathy occurring in the cervical spine. Myelopathy is a condition caused by physical compression of the spinal cord due to degenerative changes, damaging nerve cells, and it can occur in both the thoracic and cervical spine. The spinal cord is part of the central nervous system connected to the brain and is located within the spinal canal, where sensory and motor nerves converge. When the central nervous system is damaged by myelopathy, sequelae such as paralysis of motor and sensory nerves in the upper and lower limbs occur. Symptoms usually start gradually and worsen over time, often causing delays in treatment.

Myelopathy can be recognized by motor impairment symptoms. Various causes apply pressure to the spinal cord in the cervical region, causing nerve damage and resulting in multiple motor impairments. The main symptom is impairment of fine motor skills in the hands. People may easily drop objects and their handwriting may change. Using chopsticks becomes difficult, or they may have trouble buttoning shirts. Additionally, proprioceptive sensory loss due to nerve damage can cause gait disturbances such as staggering. In severe cases, controlling urination and defecation may become difficult. These symptoms usually progress very slowly, so subtle abnormal signs are often not recognized initially.

Cervical myelopathy is mainly caused by degenerative changes in the cervical spine, severe cervical disc herniation (herniated disc), or ossification of the posterior longitudinal ligament (OPLL). Spinal ligaments maintain movement between bones and support them to prevent dislocation; the anterior longitudinal ligament supports the spine from the front, and the posterior longitudinal ligament supports it from behind the vertebral body. OPLL is a condition where the posterior longitudinal ligament hardens and thickens like bone, and when this hardened and thickened ligament compresses the spinal cord located posteriorly, cervical myelopathy occurs.

Surgical Methods Vary Depending on Cause

If cervical myelopathy is suspected, an MRI scan of the cervical spine is performed to confirm the diagnosis. MRI is important for diagnosing spinal diseases, assessing the degree of nerve compression, and deciding on surgical treatment and methods.

Once diagnosed with cervical myelopathy, surgery is the safest treatment. Currently, the medical community generally agrees that symptoms of cervical myelopathy do not improve without surgery. If diagnosed at a stage where symptoms have significantly worsened, surgical outcomes may not be as favorable as expected. In some cases, surgery may be performed to prevent further deterioration.

Surgical methods vary depending on the cause. Cervical myelopathy caused mainly by degenerative changes or severe herniated discs is treated by anterior cervical discectomy and fusion to relieve spinal cord compression. In contrast, cervical myelopathy caused by OPLL is treated by posterior approaches such as posterior decompression or laminoplasty.

After surgery, hand movement and walking ability recover over several months to a year. However, if symptoms have lasted a long time or the spinal cord is severely compressed causing structural nerve changes, or in elderly patients over 70 years old, the degree of neurological recovery after surgery is relatively limited.

Correct Posture is Important for Prevention

It is important to receive appropriate treatment early for cervical myelopathy to maintain as much function in the hands and feet as possible. Spinal degeneration is a natural phenomenon that occurs with aging, making it difficult to completely prevent cervical myelopathy. However, maintaining correct posture to avoid strain on the neck is recommended. Regular exercise such as walking and continuous neck exercises are also encouraged.

Professor Park Ji-won of the Department of Orthopedics at Korea University Ansan Hospital said, "In the early stages of cervical myelopathy, symptoms such as pain and numbness in the neck, shoulders, hands, and arms may appear, often leading to confusion with simple herniated discs and neglect of symptoms." He added, "Myelopathy can occur even at a young age and is a progressive disease that continuously worsens, so prompt and accurate diagnosis and treatment are crucial."

Professor Park advised, "If symptoms suspicious of cervical myelopathy appear, such as impaired fine hand movements or staggering while walking, do not hesitate to visit a nearby orthopedic clinic and get an MRI scan."