The spine and the spinal cord are among the most vital structures in the body, supporting posture and enabling sensory and motor information to travel between the brain and the rest of the body. But when the spinal cord is injured or compressed, it can lead to serious complications, including a condition called myelopathy. Myelopathy is a progressive spinal disorder that can significantly impact mobility, sensation, and overall quality of life. If left untreated, it can lead to permanent nerve damage.
Whether you have been diagnosed with this condition or are researching potential causes of pain, understanding myelopathy is essential for early detection and effective management. In this comprehensive guide, we’re taking a closer look at the causes, symptoms, diagnostic methods, and available treatments for myelopathy. We’ll also discuss when to see an orthopedic specialist for help finding long-term relief and improved quality of life.
What Is Myelopathy?
Myelopathy is a term describing spinal cord dysfunction caused by compression, inflammation, or injury. The spinal cord, a crucial part of the central nervous system, transmits signals between the brain and the body. When it becomes compressed due to degenerative changes, trauma, or other medical conditions, nerve function can become seriously impaired, leading to issues including weakness, numbness, and coordination difficulties.
Myelopathy is often progressive, meaning symptoms worsen over time if the underlying cause is not treated. While it can affect any part of the spinal cord, it is most commonly found in the upper (cervical) part of the spine, as this region is highly mobile and vulnerable to degeneration.
Types of Myelopathy
Myelopathy can be classified based on the affected region of the spine:
- Cervical myelopathy: The most common type occurs in the cervical spine. It results from compression of the spinal cord due to conditions including age-related degeneration, herniated discs, or bone spurs.
- Thoracic myelopathy: This affects the middle (thoracic) part of the spine. It is often caused by herniated discs, tumors, or spinal trauma. Since the thoracic spine is more rigid than the cervical spine, myelopathy in this region is less common.
- Lumbar myelopathy: While rare, myelopathy can also occur in the lower (lumbar) spine. The spinal cord typically ends around the L1-L2 vertebrae, so conditions affecting the lumbar spine more commonly result in cauda equina syndrome, which is different from true spinal cord myelopathy.
Causes of Myelopathy
Myelopathy occurs when the spinal cord becomes compressed or damaged, disrupting communication between the brain and the rest of the body. This condition can develop gradually due to degenerative changes or arise suddenly from an injury or illness. Understanding the potential causes of myelopathy is essential for early detection and treatment. Several underlying conditions can contribute to spinal cord compression, including:
- Degenerative diseases: Age-related conditions such as cervical spondylosis and osteoarthritis can lead to bone spurs, herniated discs, or other structural changes that narrow the spinal canal and put pressure on the spinal cord.
- Spinal trauma or injury: Car accidents, falls, and sports-related injuries can cause direct damage to the spinal cord. Even seemingly minor injuries, like whiplash, can lead to spinal compression over time.
- Autoimmune and inflammatory diseases: Conditions such as multiple sclerosis and rheumatoid arthritis can trigger inflammation around the spinal cord, leading to compression and neurological symptoms.
- Benign or malignant tumors: Growths within or near the spinal cord can exert pressure on the nervous tissue, interfering with normal function and potentially causing myelopathy.
- Infections and other conditions: Spinal infections, including abscesses and tuberculosis of the spine — a condition known as Pott’s disease — can cause inflammation and structural damage, leading to myelopathy.
- Spinal stenosis: A condition in which the spinal canal narrows; spinal stenosis places excess pressure on the spinal cord, often worsening with age.
Identifying the root cause of myelopathy is key to determining the best course of treatment. Whether the condition stems from gradual degeneration or a sudden injury, early intervention can help prevent further complications and improve overall spinal health. If you are experiencing symptoms of myelopathy, consulting a specialist can help you explore the most effective treatment options.
Symptoms of Myelopathy
Symptoms of myelopathy often develop gradually and worsen over time. The severity and type of symptoms depend on which part of the spine is affected. Common symptoms of myelopathy include:
- Neck or back pain, depending on the location of compression
- Weakness in the arms or legs
- Numbness or tingling sensations in hands, fingers, or feet
- Difficulty with coordination and balance
- Loss of fine motor skills, such as trouble buttoning shirts or writing
- Urinary urgency or incontinence in severe cases
- Spasticity or stiffness in muscles
If left untreated, myelopathy can lead to permanent nerve damage, paralysis, or loss of bladder and bowel control.
Diagnosing Myelopathy
Early diagnosis is key to preventing worsening symptoms. If you experience persistent neck pain, weakness, or balance issues, your doctor may recommend the following:
- Physical examination: To assess muscle strength, reflexes, and coordination.
- MRI (Magnetic Resonance Imaging): An MRI is often the most effective imaging service to detect spinal cord compression, inflammation, or tumors.
- CT scan with myelogram: Helps visualize the spinal canal and nerves using contrast dye
- X-rays: To check for bone spurs, fractures, or spinal alignment issues.
- Electromyography (EMG) and nerve conduction studies: To assess nerve function and rule out other neurological conditions
Treatment Options for Myelopathy
Treatment for myelopathy depends on the severity of symptoms and the underlying cause. Therapeutic options generally range from conservative management to surgical intervention.
Common nonsurgical treatment options include:
- Physical therapy: working with a physical therapist can help improve strength, balance, and coordination.
- Pain management: Medications such as ibuprofen or interventional pain management steps such as corticosteroid injections can reduce inflammation.
- Bracing: A neck or back brace may help stabilize the spine.
- Lifestyle changes: Weight management, posture correction, and avoiding high-impact activities.
If symptoms are mild to moderate, conservative treatment can help manage pain and slow progression. But if a full course of initial therapies has been attempted without offering relief and nerve damage is worsening, spine surgery may be necessary.
Surgical Procedures for Myelopathy
If conservative treatments have been fully explored without bringing the relief necessary for a good quality of life, spine surgery can become the best option for relieving spinal cord compression and preventing further deterioration. The type of surgery depends on the location and cause of myelopathy.
Common surgical procedures for myelopathy include:
- Fusion procedures: Removal of a damaged disc or bone spurs followed by spinal fusion to stabilize the area.
- Laminectomy: Removal of a part of the vertebra, known as the lamina, to create more space for the spinal cord.
- Laminoplasty: Reshaping the lamina to expand the spinal canal while preserving motion.
- Decompression surgery: Used to relieve spinal cord compression by removing displaced or damaged tissue around the spinal cord.
Specific procedures often use a minimally invasive approach involving smaller incisions, less muscle disruption, and faster recovery. Patients can expect significant symptom relief after surgery, but post-operative rehabilitation is crucial for optimal recovery.
When to See an Orthopedic Specialist
If you experience persistent neck pain, weakness, or difficulty walking, don’t ignore the symptoms. Seek medical attention if you have:
- Worsening weakness or numbness in arms or legs
- Loss of hand coordination or dropping objects frequently
- Difficulty walking or maintaining balance
- Bladder or bowel dysfunction
An orthopedic or spine specialist can evaluate your condition and determine the best course of treatment.
Overcoming Myelopathy
Myelopathy is a serious spine condition that can significantly impact daily life. While early symptoms may seem mild, delaying treatment can lead to permanent nerve damage. Understanding the causes, symptoms, and treatment options — including both conservative management and surgical intervention — can help patients make informed decisions about their spinal health.
If you or a loved one experiences symptoms of myelopathy, one of our expert orthopedic specialists can work with you to help prevent further complications and improve your quality of life. With proper treatment, many individuals regain mobility and relief from pain, allowing them to lead active, fulfilling lives.
At The Orthopedic Clinic, we prioritize compassionate, patient-focused care, understanding that orthopedic treatment extends beyond just addressing the condition. Our skilled and dedicated team takes the time to consider your lifestyle and personal health objectives before tailoring a treatment plan that suits your needs. If you’re dealing with myelopathy, we offer a comprehensive range of treatment options designed to provide the relief you deserve. Reach out to us today to explore how we can support your journey to better health.