By looking at MRI scans, the team were able to identify a larger amount of fatty tissue in two neck muscles, directly above and below the point of spinal cord compression. A larger build-up of fat cells was found to be linked to heightened symptoms of CSM, such as taking longer to walk 30m, and more difficulty with movement. They also found that patients with unevenness in one of their other neck muscles reported greater neck pain, and associated problems.
The increase of fat cells in muscle can be linked to a number of causes, but is most often seen as a normal part of the ageing process. Previous research has already found that we can reduce this age-related build-up of fat using physical activity and regular exercise (2), so the Canadian team speculate that a scheme of targeted neck exercises might help to improve the results of surgery in the treatment of CSM.
It’s important to remember however, that this research is still in its early days, and that so far, and a number of questions remain unanswered:
- Can neck exercises reverse fat infiltration?
- if so, what type of exercises are appropriate?
- Does this improve patient symptoms?
- Is it a consequence of CSM, or related to its origins?
It should be remembered that neck exercises will not remove the compression behind CSM and that at present, this can only be treated with surgery. Additionally some suggest extensive neck therapy before surgical treatment can make symptoms worse. (3) More work will need to be done to see whether the possible benefits of exercise are actually seen in patients, and if so, which types of exercises are most useful. However, if the suggestions made in this paper are found to be accurate, then this could be a simple way for patients to change the way that they prepare for surgery, in order to improve results.
(1) Fortin M, Dobrescu O, Courtemanche M, Sparrey CJ, Santaguida C, Fehlings MG,Weber MH. Association Between Paraspinal Muscle Morphology, Clinical Symptoms and Functional Status in Patients With Degenerative Cervical Myelopathy. Spine (PhilaPa 1976). 2016 May 23
(2) Hamrick, Mark W., Meghan E. McGee-Lawrence, and Danielle M. Frechette. “Fatty Infiltration of Skeletal Muscle: Mechanisms and Comparisons with Bone Marrow Adiposity.” Frontiers in Endocrinology 7 (2016): 69. PMC. Web. 15 Feb. 2017
(3) Rhee JM, Shamji MF, Erwin MW, Bransford RJ, Yoon T, Smith JS, Kim HJ, Ely CG, Dettori JR, Patel AA, Kalsi-Ryan S. Nonoperative management of cervical myelopathy: a systematic review. Spine
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