Myelopathy refers to any condition in which the spinal cord tissue is severely compressed, causing dysfunction of the spinal cord. While myelopathy can occur due to trauma (injury) or congenital stenosis (spinal canal narrowing due to a birth defect), it is typically caused by degenerative conditions that affect older adults. In fact, cervical myelopathy is the most common spinal disorder for Americans over age 55.
Myelopathy can occur in any area of the spine; however, it most commonly affects the cervical spine (neck). It is less common in the mid (thoracic) or lower (lumbar) spine.
While osteoarthritis, which is referred to as wear-and-tear damage, is the most common cause of spinal cord dysfunction (myelopathy), there are a number of other possible causes. These include:
Myelopathy can cause a variety of symptoms, mostly related to abnormal or impaired functioning. However, a great number of cases of cervical spinal compression are asymptomatic (without symptoms). Therefore, it is important that those cases be detected and monitored so that the condition does not become worse, causing actual dysfunction.
A careful analysis is required to determine the presence of myelopathy or spinal cord compression. It begins with the doctor taking a thorough medical history and conducting a neurological examination, which includes evaluation of sensory and motor functions.
Sensory exams explore:
Motor function tests include:
Possible imaging tests include X-rays and magnetic resonance imaging (with or without myelography to enhance other imaging results). Imaging results are combined with the other components of the doctor’s exam and medical history in order to confirm a diagnosis.
Diagnosis is critical for this condition. Most often, for those who are symptomatic, those symptoms increase over time. While it may be very rare, progressive myelopathy can lead not only to weakness but also to paralysis.
A number of noninvasive, conservative measures may provide relief for myelopathy, depending on the type and extent of the condition. These include:
While these measures may help relieve symptoms and manage the myelopathy, they cannot prevent it. If symptoms do not improve or they progress with this type of noninvasive treatment, and pain is incapacitating and function severely diminished, surgery may be recommended. The goal of surgery is to relieve symptoms by “decompressing” the spine. This is done by creating more space for the spinal cord.
Surgery may include a laminoplasty, which is spinal decompression without fusion. When spinal decompression with fusion is indicated, it can be either anterior spine decompression (which is done from the front), or posterior spine decompression (done from the back).
At University Orthopaedic Associates (UOA), we bring 45 years of experience to the diagnosis and cutting-edge treatment of spine conditions. This includes Myelopathy/spinal cord compression. Contact us for a consultation.