What is Myelopathy?

Myelopathy is a condition that occurs due to compression of the spinal cord. This can interfere with the signals traveling between the brain and the rest of the body. It is often linked to spondylosis, a condition caused by the gradual degeneration of the intervertebral discs. 

Types of Myelopathy

Myelopathy can be categorized depending on the part of the spine where the spinal cord is affected. This includes: 

• Cervical Myelopathy: This is the most common type. It occurs when the spinal cord is compressed in the neck region.
• Thoracic Myelopathy: Develops when the spinal cord is compressed in the mid-back region. 
• Lumbar Myelopathy: It occurs in the lower back. This type is rare because the spinal cord typically ends just above the lumbar spine, around the first or second lumbar vertebra.

Myelopathy vs. Radiculopathy

Myelopathy occurs when the spinal cord itself is compressed. Since the spinal cord carries signals between the brain and the rest of the body, compression can affect multiple areas below the level of the injury. On the other hand, radiculopathy happens when spinal nerve roots that branch from the spinal cord are compressed, causing pain that follows a specific nerve root.

Causes of Myelopathy

There are many reasons why the spinal cord may become compressed, leading to myelopathy. In some cases, the changes happen gradually over time due to aging, while in others, they may occur suddenly from injury or disease. Some of the more common causes include:

• Intervertebral disc herniation: When the soft inner portion of a spinal disc pushes through a tear in the outer layer, it can press against the spinal cord. This pressure may interfere with normal nerve signaling. 
• Spinal stenosis: This is the narrowing of the spinal canal, reducing the space available for the spinal cord. This gradually increases pressure on the spinal cord. It is often linked to age-related changes such as arthritis.
• Spinal tumors: Abnormal growths, whether benign or malignant, can develop within or around the spinal cord. As these tumors enlarge, they may press against the spinal cord or surrounding structures, disrupting normal function.
• Injury to the spine: Traumatic events such as falls and car accidents can damage the vertebrae or surrounding tissues. This trauma may cause direct pressure on the spinal cord or create instability that leads to compression.
• Autoimmune conditions: Disorders such as rheumatoid arthritis can trigger inflammation that damages the spinal cord or surrounding structures. This immune response may lead to swelling or other changes that can compress the spinal cord.

Symptoms of Myelopathy

The signs of myelopathy can vary depending on the part affected and how severe the compression is. Symptoms often develop gradually but may worsen over time if left untreated. Common symptoms include:

• Pain in the neck, back or limbs 
• Numbness or tingling
• Weakness in the limbs
• Balance and coordination issues
• Loss of fine motor skills 
• Poor bowel or bladder control

How Myelopathy Is Diagnosed

The condition can mimic other spinal or nerve problems. This is why our specialists use several approaches to confirm it. These include:

• Symptom review: Your doctor will ask about pain, weakness, balance issues or changes in bladder and bowel control. They will also check muscle strength and coordination.
• Imaging tests: This may include an MRI, X-ray and a CT scan. MRI is most preferred as it can provide detailed images of the spinal cord and detect compression, herniated discs or tumors. CT scans can also be used to evaluate the bone changes and tumors, while X-rays can only detect fractures or bone spurs and not the soft tissues.
• Nerve function tests: Electromyography (EMG) and nerve conduction studies can help determine how well the nerves send signals and identify the areas where compression occurred.

Treatment Options for Myelopathy

The treatment plan for myelopathy depends on the cause and severity of symptoms. In some cases, conservative methods may help manage discomfort, but because myelopathy involves compression of the spinal cord, surgery is often necessary to prevent permanent damage.

Non-surgical Treatments for Myelopathy

• Medications: Pain relievers and muscle relaxants may ease discomfort. 
• Physical Therapy: Helps improve mobility, strengthen muscles and reduce stiffness.
• Lifestyle Adjustments: Activity modification and posture correction may provide temporary relief.

Surgical Treatments for Myelopathy

Surgery is usually recommended when conservative methods are ineffective or symptoms are progressing. This will help relieve pressure on the spinal cord and stabilize the spine. Surgical options include:

• Laminectomy: It removes part of the vertebra (lamina) to create more space for the spinal cord.
• Microdiscectomy: It removes a herniated disc that is pressing on the spinal cord.
• Spinal fusion: Involves joining two or more vertebrae to stabilize the spine after decompression.

Tumor removal: It is ideal in cases where a spinal tumor is causing compression.

Prognosis for Myelopathy

When spinal cord compression is identified in its early stages and managed promptly, many patients experience significant improvement in symptoms. These include:

• Improved mobility 
• Reduced pain and stiffness
• Restored hand and arm function
• Decreased numbness or tingling in the limbs
• Better bladder and bowel control

Take Control of Your Spine Health 

Our specialists at Neurosurgical Associates of Central Jersey, P.A., have extensive experience diagnosing and treating myelopathy throughout the spine, regardless of severity. Call us today to schedule a consultation in our Bridgewater, NJ office.