An Ayurvedic Approach to Extra-Dural Extra-Medullary Compressive Myelopathy

Abstract

Compressive myelopathy is a progressive neurological disorder caused by mechanical compression of the spinal cord, most commonly due to degenerative cervical spine changes. It leads to motor, sensory, and autonomic deficits with significant functional impairment. This report presents the Ayurvedic management of a patient with degenerative extra‑dural, extra‑medullary cervical compressive myelopathy. A 62‑year‑old male with a history of cervical trauma and multilevel cervical spondylosis presented with quadriparesis, spastic gait, hand clumsiness, paraesthesia, and neck pain. Magnetic resonance imaging demonstrated multilevel disc‑osteophyte complexes, ligamentum flavum hypertrophy, severe canal stenosis, ventral cord compression, and intramedullary edema. Based on Ayurvedic evaluation, the condition was diagnosed as Sarvangavata with Vata predominant Tridosha vitiation involving Asthi and Majja dhatus. Ayurvedic treatment protocol comprising internal medications, external therapies, Shodhana procedures, Nasya, Shirodhara, Matravasti, along with dietary and lifestyle modifications was administered. Clinical outcomes were assessed using neurological examination, pain scores, Nurick grading, and the modified Japanese Orthopaedic Association (mJOA) scale. Following treatment, the patient showed marked reduction in neck pain and paraesthesia, improvement in hand grip strength, muscle power, gait stability, and functional activities. The mJOA score improved from moderate to mild disability, indicating significant neurological recovery. This case suggests that individualized Ayurvedic management may serve as a complementary therapeutic option in Extra dural Extra medullary Compressive Myelopathy.