Myelopathy

What is Myelopathy?

Myelopathy occurs when the spinal cord is damaged and chronic back pain symptoms develop. This condition can occur anywhere along the spinal cord, but it most commonly affects the neck or cervical area. “Cervical spondylotic myelopathy (CSM) is a neck condition that arises when the spinal cord becomes compressed—or squeezed—due to the wear-and-tear changes that occur in the spine as we age,” said the American Association of Orthopaedic Surgeons (AAOS).

What Are the Common Myelopathy Causes?

The damage to the spinal cord is typically from trauma or spinal stenosis (narrowing of the spinal canal). Spinal stenosis that is severe or chronic may cause myelopathy.  Damage to the spinal cord may be irreversible. Some common causes of myelopathy include the following:

• Spinal stenosis—This condition occurs when the canal that holds the spinal cord and nerves becomes too narrow.
• Disc herniations—”As disks deteriorate with age, they become more prone to herniation. A herniated disk often occurs with lifting, pulling, bending, or twisting movements,” said the AAOS.
• Bone spurs—”Inflammation can cause the erosion of the cartilage in the joint that would normally allow for smooth gliding and motion of the two adjacent articulating vertebrae,” said Dr. Mark Valente of the DISC Spine Institute. “The loss of cartilage in the joint and bone spurs can cause restricted motion and pain.”
• Spinal trauma such as a car accident
• Spinal infections
• Autoimmune diseases like rheumatoid arthritis
• Oncological disorders like spinal tumors
• Neurodegenerative diseases like amyotrophic lateral sclerosis (ALS) or Parkinson’s

What Are the Common Myelopathy Symptoms?

Early symptoms of myelopathy are imbalance with standing and walking, and difficulty with fine motor movements of the hands.  Patients may experience one or all of the following:

• Difficulty picking up fine objects like coins or pieces of paper
• Difficulty holding onto things or dropping things unexpectedly
• Unable to pull buttons through on clothing
• Worsening of handwriting

In extreme cases, there may be a loss of the function of the bowel or bladder.  Patients may develop pain, weakness, clumsiness, spasticity, and hyperreflexia. Because myelopathy is potentially irreversible it is important to consult your spine specialist to evaluate whether or not you indeed have signs or symptoms of myelopathy.

What Are Common Myelopathy Treatments?

Treatments can range from observation of the symptoms to make sure they don’t progress or worsen to surgical decompression of the spinal cord.  Depending on the location of the compression you may or may not be a candidate for a minimally invasive procedure.

Age is a factor, as myelopathy most commonly affects patients over the age of 50. But this can also make the condition hard to diagnose if patients chalk that pain up to aging and don’t see a doctor.

“Oftentimes, the condition is missed or treated as a normal consequence of aging,” said Very Well Health. And because Myelopathy is degenerative, symptoms can continue to worsen if left unchecked. “Because this condition can be progressive, early recognition and treatment are vital to improving outcomes before irreversible spinal cord damage has occurred.”

Once a diagnosis of myelopathy has been made, the doctor can develop a treatment plan. The renowned spinal doctors at the DISC Spine Institute approach myelopathy and every other spinal condition from a conservative standpoint that avoid surgery whenever possible. Myelopathy responds well to non-surgical treatments like physical therapy and non-steroidal anti-inflammatory medications (NSAIDs) in more mild cases.

What Are Typical Myelopathy Surgery Procedures?

If conservative treatments don’t vastly improve the patient’s condition, it may be time for surgery. “There are several procedures that can be performed to help relieve pressure on the spinal cord,” said the AAOS. “The procedure your doctor recommends will depend on many factors, including what symptoms you are experiencing and the levels of the spinal cord that are involved.”

Common surgical procedures used to treat myelopathy include spinal fusion, laminoplasty, and laminectomy. “Minimally invasive non-fusion surgeries include endoscopic discectomies and endoscopic laminectomies that can be performed through incisions less than half an inch and require just a band-aid,” said the DISC Spine Institute.

“These procedures require no sutures to remove. Muscle fibers, ligaments, and tendons are meticulously preserved. There is less operative time, less anesthesia, and less blood loss, and they’re performed on an outpatient basis, which allows you to return to work and back to a pain-free lifestyle quicker than traditional surgery.”

When you see a doctor for myelopathy, you can expect to have a thorough examination, including a review of your symptoms and your complete medical history. Tests may include X-rays, MRI scans, and CT scans, which are particularly useful in determining if bone spurs have developed along the spine.

If you’re ready to put an end to your pain or if you want more information about treatment options, contact the DISC Spine Institute, experts in minimally invasive treatments, the most effective medical procedures to treat and eliminate chronic back pain. Today’s minimally invasive procedures include outpatient treatments and easier surgical treatments with small incisions and a quicker recovery time instead of a long hospital stay.