Myelopathy is used to describe any loss of activity in the spinal cord due to either natural spinal degeneration or sudden injury. The term specifically refers to a spinal cord injury from severe compression that can be due to things like disc herniation, degenerative disease, congenital stenosis, or trauma.
Some people experience confusion distinguishing between myelopathy and radiculopathy, especially since they sometimes go hand in hand, according to John Hopkins Medicine. Radiculopathy is the actual pinching of nerves roots when they exit your spinal cord or as they cross your intervertebral disc. Myelopathy, in contrast, refers to the spinal cord actually being compressed.
The Types of Myelopathy
Not all patients with myelopathy have an identical condition, as this spinal compression can take place in any part of the spine. The name of the myelopathy depends on where it is. Cervical myelopathy refers to spine compression in the neck, and this is the most common type.
Thoracic myelopathy affects the middle portion of the spine. This spinal cord compression is usually due to bone spurs, spinal trauma, or herniated or bulging discs. Finally, lumbar myelopathy is very rare, especially since most people’s spinal cord ends near the top of the lumbar spine. For those rare people who have a tethered or low-lying spinal cord, lumbar myelopathy is a possibility.
Understanding What Leads to Myelopathy
Pressure can develop on your spinal cord as well as its nerve roots for a wide range of reasons, leading to myelopathy. Causes of this pressure can include aging, arthritic illness, bone spurs, flattening spinal discs, and inflammation. In most cases, myelopathy will develop slowly over time due to spondylosis, or gradual spinal degeneration. That being said, it is also possible to develop myelopathy from spine deformities that are there since birth.
Degenerative spinal conditions frequently cause myelopathy. Spinal stenosis is one of the most common of these, as it narrows the bony passageways within the spine that the nerve roots and spinal cord travel through. Patients may also develop myelopathy from central disc herniations due to their compression of the spinal cord. Spinal tumors, hematomas, hernias, and cysts have also been known to cause myelopathy by pressing on the spinal cord.
It is also possible for patients to develop acute myelopathy quickly from radiation therapy, a neurological disorder, a spinal infection, a spinal injury, or an inflammatory disease.
Common Symptoms of Myelopathy
To recognize you might have myelopathy and should visit a doctor, be on the lookout for signs and symptoms. Most are related to a loss of function or sensation, discomfort, or pain. Typical symptoms include difficulty with your fine motor skills, trouble walking, issues related to coordination and balance, loss of control over urinary or bowel functions, and increased or abnormal reflexes.
Diagnosing and Treating Myelopathy
In addition to a physical examination, diagnosing myelopathy typically involves an MRI, which gives your doctor a detailed look at the spine and the spinal canal to pinpoint issues. A myelography or an electrical test to determine nerve functionality is often performed.
Treatment will typically begin with conservative measures, such as medication, physical therapy, and bracing. They work best on mild myelopathy, helping with pain as well as the ability to complete daily activities. Unfortunately, you cannot remove the spinal compression without surgery. Because of this, many patients will eventually need spinal decompression surgery to stop the myelopathy from progressing.