What is Myelopathy, and How is it Treated?

Causes of Myelopathy

Myelopathy can stem from a variety of factors, ranging from natural degenerative changes in the spine to external traumatic events. Here are some of the primary causes of myelopathy:

• Degenerative Changes: Over time, the spine can undergo wear and tear, leading to conditions such as herniated discs, spinal stenosis, and osteoarthritis, which can compress the spinal cord.
• Traumatic Injury: Accidents or injuries that impact the spine, such as falls, vehicle collisions, or sports injuries, may cause immediate damage to the spinal cord.
• Inflammatory Conditions: Diseases such as rheumatoid arthritis may lead to inflammation around the spinal cord, contributing to compression.
• Tumors: Abnormal growths, either benign or malignant, within or adjacent to the spinal canal, can exert pressure on the spinal cord, leading to symptoms of myelopathy.

Symptoms of Myelopathy

Symptoms usually develop gradually over time, but they can appear suddenly in cases of acute injury. These manifestations result from the compression of the spinal cord and the consequent disruption of nerve signals. Common symptoms of this condition include:

• Weakness in the hands, arms, legs, or feet, often leading to difficulties with coordination and fine motor skills
• Numbness or tingling sensations in the hands, arms, legs, or feet
• Loss of balance and impaired walking ability, increasing the risk of falls
• Neck pain or stiffness, which can extend to the shoulders or arms
• Changes in bowel or bladder function, including incontinence
• Electric shock-like sensations that run down the spine or into the limbs when bending the neck (Lhermitte’s sign)

How is Myelopathy Treated?

Treating myelopathy is designed to alleviate pain, restore function, and prevent further injury to the spinal cord. Each treatment method has unique advantages and considerations, and understanding these can empower patients to make informed decisions on their treatment options.

Conservative Care Options

Physical Therapy

Physical therapy aims to improve function, mobility, and overall quality of life through various exercises and techniques. Physical therapists can tailor exercise regimens targeting specific muscle groups affected by myelopathy to help strengthen them and improve coordination. This treatment option may also include stretches to reduce spine stiffness.

Bracing

Orthotic bracing can provide external support to the spine, reducing strain and pressure on the spinal cord. Braces can also help improve posture, alleviate symptoms, and prevent further damage. Wearing a brace may be particularly helpful for individuals with degenerative changes in the spine. Your doctor can recommend the most suitable type of brace for your condition.

Lifestyle Modifications

Making lifestyle changes such as maintaining a healthy weight, avoiding activities that exacerbate symptoms, and practicing good posture can help manage myelopathy symptoms. In addition, quitting smoking and reducing alcohol consumption can improve overall spinal health and reduce the risk of further damage. If you are unsure how to make these changes, consult your doctor or a physical therapist for guidance.

Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or pain relievers may help manage symptoms such as pain and inflammation. In some cases, antidepressants or anticonvulsants may be prescribed to help manage nerve pain. However, discussing potential side effects and risks with your doctor before starting any medication is crucial.

Surgical Treatments

Surgical options encompass decompression or a combination of decompression, fusion, and instrumentation to relieve pressure on the spinal cord and possibly stabilize the spine. Most patients only require decompression and do not need fusion or additional hardware like rods, screws, and plates.

Decompression

There are two primary methods:

Posterior Decompression: For compression originating from the back. This can be addressed with minimally invasive outpatient procedures, such as microlaminotomy, medial facetectomy, and microforaminotomy, avoiding large incisions and total laminectomies. No rods or screws are needed. Dr. Melamed specializes in this approach.

Anterior Decompression: For compression originating from the front, which is more common. Dr. Melamed has developed a unique non-narcotic, minimally invasive anterolateral approach to decompress the spinal cord using a high-powered microscope and live CT-guided navigation.

Get Expert Guidance on Myelopathy from The Spine Pro

If you or someone you know is experiencing symptoms of myelopathy, it’s essential to seek medical attention promptly. The Spine Pro offers comprehensive evaluation and treatment options for individuals with spinal conditions, including myelopathy. Remember, early intervention is key to managing myelopathy and preventing long-term complications. Don’t wait until symptoms worsen — contact The Spine Pro for expert care and support.