What is myelopathy?
Myelopathy is a traumatic damage to spinal cord as a result of massive compression that can result from trauma, congenital or inherited stenosis or degenerative diseases, as well as disc herniation. It is a set of nerves that are housed within the spine and runs all the way. If any part that is located in the spine gets constricted or compressed, the symptoms are referred to as myelopathy.
Myelopathy Versus Myopathy
Myopathy is a condition that affects the muscles and is not to be misinterpreted as myelopathy that is a result of damage to the spine.
Myelopathy Versus Radiculopathy
Myelopathy can be caused by radiculopathy. Radiculopathy is the name used to describe the pinching of nerve roots when they leave into the spinal cord, or cross the disc between the vertebrae, instead of the compression of the cord (myelopathy).
Types of Myelopathy
Myelopathy can be seen in any part of the spine. It has an alternative name, based on the area of the spine it is located.
Cervical Myelopathy
Cervical myelopathy can be found in the neck, and is the most prevalent form of myelopathy. Neck pain is among the signs of cervical myelopathy. However not all patients suffer from it.
Thoracic Myelopathy
Thoracic myelopathy is a condition that occurs in the middle in the spinal column. The the spinal cord in this region is usually compressed by discs that are bulging or herniated bone spurs, bulging discs, or injuries to the spine.
Lumbar Myelopathy
Lumbar myelopathy is a very rare condition due to the fact that in the majority of people the spinal cord is located at the top of the spinal column. If you have a spinal canal that is lying low or tied to a tether, it may be affected by lumbar myelopathy.
Causes of Myelopathy
As you get older the risk of arthritis, inflammation bone spurs, as well as the deformity of the spinal discs that lie between the vertebrae could create tension on the spine as well as its nerves. Myelopathy usually develops slowly as a result of the loss of spinal function (spondylosis) However, it could also manifest in an acute form or arise from a spinal deformity that is which is present at birth.
Myelopathy is a common cause of degenerative spinal conditions like spinal stenosis. which is a narrowing of the bony passageways within the spine through which nerve roots and the spinal cord traverse.
Herniated discs in the central disc can result in compression of the spinal cord, which can lead to the development of myelopathy.
Autoimmune conditions, such as Rheumatoid Arthritis in the spine, may result in degenerative changes of the vertebrae, which can result in spinal cord compression as well as myelopathy.
Herniasand cysts, hematomas along with spinal tumours such as bone cancer, could impact the spinal cord and contribute to myelopathy.
Acute myelopathy can be triggered quickly due to an injury to the spinal column, a inflammatory disease, spinal infection and radiation therapy, as well as neurological diseases.
Here is an example for how herniated disk could press down on the cord of the spinal column, causing myelopathy.
A diagram that shows how an infected disk could cause stress on the spine that results in myelopathy.
Symptoms of Myelopathy
If the spinal cord is damaged or compressed it can cause decrease in sensation or function, or discomfort or pain in the region below the point of compression. Myelopathy symptoms can be characterized as:
Leg, arm, neck or lower back discomfort
Numbness, tingling, or weakness
Fine motor difficulties like making a button or writing
Reflexes that are more intense in extremities or the creation of abnormal reflexes
It is difficult to walk
Inability to maintain urinary or bowel control
Problems with coordination and balance
The exact signs will vary depending on the location in the spine myelopathy are symptoms present. For instance cervical myelopathy is more likely to be symptomatic in the neck and arms.
Myelopathy Diagnosis
Myelopathy symptoms aren’t specific to this condition. Your physician may suggest the following tests to help narrow the myelopathy diagnosis
An X-ray is used to determine if there are any other issues
An MRI scan can provide a thorough examination of the spine as well as the spinal canal. It may reveal the areas of stenosis.
Myelography employs an contrast material and real-time versions of X-rays called fluoroscopy, to detect abnormalities in the cord of the spinal. It’s sometimes utilized instead of MRI for patients who cannot be placed in the MRI machine.
The electrical tests, like an electromyogram, or somatosensory evoked potentials, demonstrate how your nerves work to provide sensation and capability to your legs and arms. These tests determine the extent to which nerve stimulation in a hand or leg, arm or foot is transferring via the spinal cord to the brain.
The diagnosis may be made known via your physician in various ways. Sometimes, myelopathy may be added after an underlying condition to show an involvement in the spinal cord. For instance, your doctor might inform you that you suffer from cervical stenosis that is myelopathy, or thoracic disk disorder with myelopathy. If the spinal cord isn’t involved the diagnosis could be with no myelopathy as in the displaced intervertebral disc of the lumbar spine with no myelopathy.
When myelopathy occurs as a result of a different disease or condition, your physician may use it in the terms of the condition. For instance the term diabetic myelopathy refers to the spinal cord is damaged by the disease of diabetes. Carcinomatous myelopathy indicates that your spinal cord been affected from a cancer.
Myelopathy Treatment
Myelopathy treatment is based on the causes that cause myelopathy. In some instances the cause could be irreparable, which means that the treatment will be limited to aiding in relieving symptoms or slowing any further progress of the disorder.
Nonsurgical Myelopathy Treatment
Myelopathy treatment that is non-surgical may include physical therapy, bracing and medications. These treatments are effective to treat mild myelopathy. They are designed to reduce the pain and aiding you in returning to normal activities.
Nonsurgical treatments do not eliminate the compression. The symptoms may worsen -typically slowly however, they may be acute in certain situations. If you begin to notice a change in your symptoms, speak to your doctor as quickly as you can. Certain stages of progression could be irreversible despite treatment that’s why it is crucial to stop any progress once it is detected in the early phases.
Surgical Myelopathy Treatment
A spinal decompression procedure is a standard treatment for myelopathy that relieves tension on the spine. The procedure is also a method to eliminate bone spurs and herniated discs, if they’re discovered to be the reason of myelopathy.
If you have a severe myelopathy resulting from stenosis or avascular disease, your doctor could suggest surgery to widen the channel in your spine (laminoplasty). It is a motion-sparing process which means that the spinal cord remains flexible near the point of compression. Due to various reasons, certain patients are not suitable for laminopasty. A possible alternative is decompression or spinal fusion which can be performed either frontally (from from the front) or laterally (from from behind). In a spinal fusion procedure the vertebrae fused together to prevent movement in the affected segment that is the vertebral column.
Minimally invasive spinal surgery could provide relief, with a lower chance of complications, and could lead to a quicker recovery than open-surgeon procedures.
If you’re in the midst of surgery and recovery, a combination of workout or lifestyle modifications treatment with cold and hot injections or oral medications can help manage any pain-related symptoms. It’s crucial to use every medication exactly according to the prescriptions of your physician as many pain medications and muscle relaxers may produce side effects, particularly when used for an extended duration.