Myelopathy

What is myelopathy?

Myelopathy is a group of symptoms resulting from severe compression of the spinal canal, the tunnel that runs along the inside of the spinal bones. Compression can lead to pain, numbness or difficulty moving certain parts of the body. When the compression becomes severe enough, damage can be done to the nerves or lead to neurological problems such as issues with fine motor skills.

Myelopathy types vary based on the location of it within your spine, with the most common type being in the neck (cervical myelopathy).

There are nonsurgical and surgical treatments available for myelopathy.

Causes of myelopathy

Myelopathy is usually caused over time by conditions that slowly break down the spine, such as spondylosis. Other conditions that can cause myelopathy include:

• Cervical spinal stenosis
• Lumbar spinal stenosis
• Herniated disc
• Parkinson’s disease or other neurodegenerative diseases

Types of myelopathy

The type of myelopathy is determined by the location of compression within your spine.

• Cervical myelopathy – occurs in the neck area and is the most common type of myelopathy
• Thoracic myelopathy – occurs in the middle area of your back and is usually caused by bulging or herniated discs
• Lumbar myelopathy – while rare, this appears in the lumbar spine (the lower back area)

Difference between myelopathy and radiculopathy

Myelopathy and radiculopathy are two different conditions that may at first seem similar based on your symptoms. Myelopathy refers to the compression of the spinal cord, while radiculopathy is a condition of the compression of the nerves (not the spinal cord itself).

Symptoms of myelopathy

The severe compression of your spinal cord can affect nerves that control many of your body’s movements and functions. You may experience:

• Numbness or loss of sensation in extremities
• Pain in the neck, back, arm or lower body
• Weakness or tingling
• Difficulty with fine motor skills like buttoning a shirt
• Problems walking
• Loss of bladder/bowel control (in severe cases)
• Lack of balance and coordination

Your specific symptoms will depend on the type of myelopathy. For example, if you have cervical myelopathy, you’re more likely to experience symptoms in the neck area.

How is myelopathy diagnosed?

Your doctor will conduct a thorough physical exam and ask about your medical history to diagnose your condition. Your doctor may also order the following tests:

• Imaging tests, such as magnetic resonance imaging (MRI) scans, X-rays or computed tomography (CT) scans (with or without myelography, a contrast dye in spinal fluid to help better show compression of the spine)
• Nerve conduction studies to determine whether nerves are functioning normally

How serious is myelopathy?

There is no cure for myelopathy. However, treatments may help relieve your symptoms and pain.

How is myelopathy treated?

While myelopathy may be irreversible, Ohio State Spine Care specialists can help slow down the progression and relieve symptoms that cause you pain.

Your treatment plan may first address an underlying issue that has caused the myelopathy, such as an infection or, rarely, a tumor.

Nonsurgical treatment

If your pain is minor, your doctor may recommend the following nonsurgical treatments:

• Medication to manage pain
• Physical therapy to strengthen muscles and improve balance

Surgical treatment

If nonsurgical treatments are unsuccessful or you still have pain, you may decide to choose surgery.

Decompression surgery can relieve pressure and remove herniated discs, cysts or bone spurs. Your decompression surgery may also, but not always, include spinal fusion surgery to eliminate motion in the impacted area of the spine.

Unfortunately, it’s possible you may have a recurrence of symptoms after surgery.