Myelopathy is a cord problem, not just a pain problem. Waiting for it to “settle” can allow permanent injury. Evaluation includes a careful neurologic exam — Dr. Li has published the coin test as a complementary way to assess upper-extremity function in cervical myelopathy.
Treatment is tailored to the pattern of compression and the shape of the neck. Motion-preserving laminoplasty can decompress multiple levels while keeping cervical motion. Disc replacement or ACDF may be chosen for front-of-the-neck compression, sometimes as a hybrid.
The aim is not a dramatic incision. It is a durable, cord-protecting reconstruction that lets patients keep looking over their shoulder and tying their shoes.