A disorder in which the spinal cord is compressed is called myelopathy. It often causes pain, numbness, and difficulty moving certain parts of the body. While myelopathy can happen after a traumatic injury, natural aging, or a herniated disk may also cause it. People who leave it untreated may notice that their symptoms worsen. Doctors often treat this condition with surgical and nonsurgical options.
In other words, myelopathy occurs when something puts pressure on the spinal cord, and it cannot function normally. Typically, the spinal cord consists of multiple nerves that carry signals between the brain and the rest of the body. It is located inside the spinal canal in your back. In general, there are multiple health conditions that can weaken vertebrae (protective bones in your spine) and compress the spinal cord.
Types of Myelopathy
Healthcare professionals have divided this disorder into 3 types based on which part of the spine is affected. These include:
- Cervical myelopathy – This type occurs due to a compression in the neck. Moreover, the most common subtype of cervical myelopathy is degenerative cervical myelopathy (also known as cervical spondylotic myelopathy). It often occurs in older adults due to natural changes to the spine.
- Thoracic myelopathy – In such cases, the compression occurs in the middle region of the spine (the mid and upper back, also called the thoracic spine).
- Lumbar myelopathy – It occurs when something compresses the lower part of the spine (also called the lumbar spine).
Symptoms
Usually, people who develop myelopathy experience the following symptoms. Check some general symptoms below:
- Numbness, tingling, or weakness in the hands, arms, legs, or feet
- Problems with coordination and balance
- A lack of bowel or bladder control
- Pain in the back or neck
- Reduced fine motor skills (such as buttoning a shirt or grasping small objects)
Most of the time, people with myelopathy experience different symptoms because they depend on the type and severity of the condition, existing health problems, age, gender, and other factors. In normal circumstances, the spinal cord contains multiple nerves that control different body functions. If any of the previous symptoms occur, immediately contact your healthcare professional.
Causes and Risk Factors
There are multiple things that can compress your spinal cord and cause this disorder. Check the most common causes below:
- Spinal stenosis
- Neurodegenerative disorders (including Parkinson’s disease and ALS)
- Infections
- Inflammation
- Herniated disk
- Traumatic injuries to the back
- Tumors
- Spondylosis
While anyone can develop myelopathy, the following factors could elevate your risk even more. Examples include:
- Gender – Some research shows that males are slightly more prone to myelopathy than females.
- Age – In older adults, the vertebrae tend to weaken as a normal part of aging. That’s why myelopathy happens more frequently in people over 50 years old.
- Congenital stenosis – Some people may develop this condition, which narrows the spinal canal where the spinal cord sits. As a result, it leads to spinal cord compression.
- Occupational and sports hazards – These include heavy lifting or repetitive neck and/or back motion.
- Other health conditions – For example, rheumatoid arthritis, tumors, infections, metabolic deficiencies (including reduced levels of vitamin B12), and others.
What Happens if Myelopathy is Left Untreated?
While most people with myelopathy do not experience complications, in more severe cases, they can experience the following complications. Check some examples below:
- Paralysis
- Mobility problems – These include impairment in balance, walking, and coordination.
- Autonomic dysfunction – For example, loss of bowel or bladder control.
- Decreased motor function
- Severe chronic (long-term) pain
- Permanent neurological deficits, which can lead to sensory loss and progressive weakness.
- Treatment complications – These include pulmonary embolism, dysphagia, spinal fluid leaks, wound infections, hematomas, and others.
The previous list does not contain a full list of myelopathy complications, but you can talk with your healthcare professional about measures to reduce the risk or even prevent them.
Is There a Way to Prevent Myelopathy?
Unfortunately, it is not always possible to prevent this condition because in older adults, it occurs from normal wear and tear caused by aging. However, doctors may recommend some options to strengthen the backbone. One example is to lift heavy objects correctly with your legs and core.
Diagnosis
First, physicians will perform a physical and neurological examination when they suspect myelopathy. They may also ask some questions about your medical history and symptoms to get more clues about your disorder. In any case, to confirm myelopathy and rule out other health conditions that cause similar symptoms, doctors often perform the following tests. For example:
- Imaging tests – These tests are used to get detailed images of tissues and organs throughout the body. Doctors often perform a spine X-ray, MRI (magnetic resonance imaging), or CT (computerized tomography) scans.
- Myelogram – This test involves a contrast dye that helps get clearer images of the soft tissue and bones in the spine.
- Nerve function tests – Usually, healthcare professionals perform evoked potentials or electromyography (EMG) to measure how the brain and body send signals between them.
Treatment
In most cases, doctors prescribe different treatment options for people with myelopathy because they depend on several factors, including the type and severity of myelopathy, overall health, gender, age, and preferences. Check some treatments below:
Nonsurgical Myelopathy Treatment
The following treatments are often recommended by doctors to ease the symptoms. These include:
- Wearing a brace
- Physical therapy
- Medicines – For example, Corticosteroids (to reduce inflammation) and pain relievers (to reduce pain caused by spinal cord compression).
Myelopathy Surgery
These treatments are used to decompress the spinal cord. Commonly, surgeons perform spinal decompression surgery to treat this disorder by using one or several of the following procedures. Examples include:
- Discectomy
- ACDF surgery
- Laminectomy
- Spinal fusion
- Laminoplasty
- Disk replacement
Frequently Asked Questions
When should I see a healthcare provider?
If you notice any of the following symptoms, immediately contact your physician. These include:
- Tingling, numbness, or weakness in the fingers, hands, feet, or toes
- New or worsening pain in the back or neck
- Loss of balance, walking problems, or clumsiness
What neurological disorders cause myelopathy?
Generally, there are multiple health conditions that may cause myelopathy. Some of them include autoimmune disorders (such as rheumatoid arthritis), disk herniation or degeneration, spinal stenosis, and others. For more details, discuss it with your doctor.
What is the life expectancy of a person with myelopathy?
Usually, the life expectancy of people with myelopathy varies because it depends on some factors. For example, the severity and type of the condition, your response to treatment, and others. Ask your healthcare provider if you have additional questions.
