What you should know about

Positional Cervical Cord Compression (PC3):

Treatment Options

Pacific Rheumatology Associates Inc PS

4300 Talbot Road South, Suite 101

Renton, Washington USA 98055

425-235-9500

PC3 Treatment


Thankfully, 85% of patients with PC3 can be managed non-surgically.  However, typical options used for 'arthritis' usually fail. Best candidates are those with canal narrowing between 7-10 mm diameters (normal 12-15 mm)


A new, innovative therapy program was developed locally to address what is essentially a spinal cord issue.  The cervical cord is not thought to be damaged, but intermittent compression of it appears to act as a remarkable irritant.  The treatment target is the spinal cord - not the bulging disks or arthritic bone spurs.  Much of this program has been recreated on a DVD sponsored by the National Fibromyalgia Research Association and is available to patients, therapists and clinicians interested in treating PC3.


Many options known to reduce spinal cord tissue irritation can play a therapeutic role, but medications do not replace the therapy, which teaches patients to avoid cord compression and reduce cervical instability.  Medication options should be carefully considered by patients and their treating clinicians on an individual basis, but applicable choices can include muscle relaxants, antiepileptics, antidepressants, analgesics and benzodiazepines -  although these are usually limited to those that address cord irritation and secondary autonomic dysregulation (i.e., lorazepam and clonazepam at night).

Surgery is available for those who fail to respond to pain management and therapy. Generally, but not always, these patients have cervical canal narrowing less than 6 mm in diameter (normal 12-15mm).  The Seattle area database includes over 400 surgical patients identified since 2003.  Anterior fusion is the preferred method used to widen the cervical spinal canal and stabilize damaged posterior ligamentous elements of the spine.