MYELOPATHY

What is Myelopathy?

The medical term ‘Myelopathy’ refers to a condition in which the spinal cord gets injured due to severe compression that may occur as a result of spinal stenosis, disc degeneration, disc herniation, autoimmune disorders, or other trauma. The spinal cord consists of nerves that transmit signals or messages between the brain and the rest of the body. Myelopathy occurs when the compression significantly increases enough to obstruct the transmission of signals to and from the brain and body.

Compression of any part of the spinal cord may result in nerve dysfunction along the spinal cord resulting in stiffness or pain in the back or neck, numbness, loss of balance, and coordination in the area around the compression point.

What are the Types of Myelopathy?

Myelopathy can develop at any point along the spinal cord and can occur as cervical, thoracic or lumbar, depending on the affected part of the spine.

Cervical Myelopathy

Cervical Myelopathy occurs when the compression takes place in the neck. Symptoms of cervical myelopathy include pain, stiffness, and reduced range of motion in the neck.

Thoracic Myelopathy

Thoracic Myelopathy occurs when the compression takes place in the middle region of the spine. Compression in this area of the spinal cord usually occurs due to a bulging or herniated disc, bone spurs, or a trauma to the spine. Symptoms of thoracic myelopathy may include weakness in the arms and legs and problems with walking and balance.

Lumbar Myelopathy

Lumbar Myelopathy occurs when the compression takes place in the lower part of the spine. Symptoms of lumbar myelopathy may include pain, numbness, and tingling in the lower extremities.

What are the Causes of Myelopathy?

Anything that can cause enough pressure to compress the spine can lead to myelopathy. This includes traumatic injury to the spine and degenerative conditions like arthritis, tumors, infections, and ruptured discs. Myelopathy may also develop as a result of spine deformity at birth.

Other conditions that may lead to myelopathy include:

• Spondylosis, a condition that causes gradual degeneration of the spine
• Spinal stenosis, a narrowing of the spaces within the spinal column usually due to arthritis
• Spinal tumors
• Neurodegenerative diseases
• Spinal injuries
• Ruptured or herniated discs

What are the Symptoms of Myelopathy?

Compression of the spinal cord may lead to pain, discomfort, and loss of sensation in the body depending on the affected part of the spinal cord. General symptoms of myelopathy may include:

• Tingling, numbness, or weakness in the upper and lower extremities
• Difficulty with fine motor skills, such as grasping small objects
• Pain in the neck, arm, leg, or lower back
• Development of abnormal reflexes in the upper or lower extremities
• Complete or partial loss of bladder and bowel control
• Difficulties with balance and movement

How do Spinal Specialists Diagnose Myelopathy?

The general symptoms of myelopathy do not occur with just this condition. A spinal specialist may recommend some tests to accurately diagnose myelopathy. These recommended tests may include:

• Imaging tests such as an X-ray or MRI scan for a detailed look at the spine and spinal canal
• Myelography, to detect the diseases that affect the nerves, blood vessels, and structures in the spinal canal
• Electrical tests such as electromyogram to show how well the nerves function to provide sensation to the arms and legs  

How do Spinal Specialists Treat Myelopathy?

Myelopathy treatment depends on the primary cause of the condition. A spinal specialist may recommend non-surgical procedures to relieve the general symptoms. Surgical procedures may prove necessary in the case where non-surgical procedures fail to alleviate the symptoms of myelopathy.

Non-surgical treatments for myelopathy may include bracing, physical therapy, and the use of pain relievers and steroid injections.

Surgical procedures commonly used to treat myelopathy include Laminectomy, Spinal fusion surgery, and Spinal decompression surgery.

References

Singleton, JM. Hefner, M. Spinal Cord Compression. (https://www.ncbi.nlm.nih.gov/books/NBK557604/) [Updated 2021 Feb 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Accessed 11/4/2021.

American Association of Orthopedic Surgeons. Cervical Spondylotic Myelopathy (Spinal Cord Compression). (https://orthoinfo.aaos.org/en/diseases–conditions/cervical-spondylotic-myelopathy-spinal-cord-compression/) Accessed 11/4/2021.

Phsiopedia. Myelopathy. (https://www.physio-pedia.com/Myelopathy) Accessed 11/4/2021.Merck Manual [Consumer Edition]. Compression of the Spinal Cord. (https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/spinal-cord-disorders/compression-of-the-spinal-cord) Accessed 11/4/2021.

Merck Manual [Consumer Edition]. Cervical Spondylosis. (https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/spinal-cord-disorders/cervical-spondylosis) Accessed 11/4/2021.

Dr. Atkinson, Patty (March 27, 2013). “Cervical Myelopathy”. Mayo Clinic News Network. Mayo Clinic. Retrieved 25 January 2017.