Myelopathy results from compression of the spinal cord may cause weakness of the hands and/or legs, problems with walking, balance, and coordination. Loss of normal bowel, bladder, or sexual function may develop. The condition is often painless, unless accompanied by radiculopathy, which is compression of a nerve root, which may cause radiating pain.
Myelopathy is defined as abnormal function of the spinal cord.
It has many causes:
Myelopathy is a concerning condition because it can result in loss of the use of hands or the ability to walk if left untreated. Once spinal cord damage occurs, it is often not fully reversible. Myelopathy can arise at any level of the spinal cord but most commonly arises from a problem in the neck. The usual time course for symptoms of myelopathy is a gradual onset and slow progression over months and years. Myelopathy more commonly affects adults age 50 and older.
Myelopathy most commonly comes from compression of the spinal cord due to degenerative arthritis of the spine. There are also many other possible causes that need to be evaluated by your physician.
The natural onset and time course for myelopathy is usually a slow onset and gradual progression over time. It would typically take months to years for symptoms to progress to a total loss of function. However, more rapid deterioration can occur, and it is most appropriate to be followed closely by a spinal surgeon (Orthopaedic spine speacialist or a Neurosurgeon) if you have this condition.
Myelopathy is commonly treated with surgery to stop progression of symptoms and allow the spinal cord the best chance to heal and recover. However, not every patient with myelopathy is an appropriate candidate for surgery. Each individual should have his or her own case reviewed by a spinal surgeon with experience treating this condition.
Treatment for myelopathy is based upon the underlying cause. Physical therapy and observation over time can be recommended in mild cases. Tumors and bleeding are often treated with surgical removal for diagnosis and treatment. Multiple sclerosis and inflammatory disorders are generally treated with immune suppression.
Spinal cord compression may need to be treated surgically from the front (anterior), the back (posterior), or both.
Anterior decompression includes removal of disc (discectomy) or removal of the vertebral body (corpectomy). These procedures are accompanied by either fusion or artificial disc replacement.
Posterior decompression includes removal of the lamina (roof of the spinal canal), also known as a laminectomy. This procedure may be accompanied by fusion with screws and rods. Widening of the spinal canal is also sometimes possible without complete removal of the lamina. This is known as laminoplasty.
Minimally invasive options for decompression and fusion are often available. The best treatment options for you or your loved ones should be discussed in detail with a spinal surgeon.