Myelopathy takes place when there is compression of the spinal cord and resulting damage of the spinal nerves. This interrupts the nerve transmissions and impairs their function. It frequently occurs in the cervical (neck) region and becomes more common as we age.
There are numerous causes for myelopathy. Some of the most common are trauma, autoimmune or inflammatory disorders, tumors and degenerative diseases such as herniated disks and spondylosis. Anything that can result in spinal stenosis, a narrowing of the spinal canal, can bring about myelopathy.
Symptoms
The symptoms experienced by people with myelopathy may differ based on what part of the spinal cord is being compressed. The progression of symptoms can also vary widely from person to person. If the arms are affected, the patient may have weakness, clumsiness or unsteadiness in their hands. If the legs are affected, the patient may experience weakness or numbness while walking. Abnormal reflexes and muscle spasms may be present. Less commonly, loss of bowel or bladder control takes place.
Diagnosis
To diagnose degenerative disc disease, your doctor will perform a physical evaluation and review your medical history. The physical examination typically entails inspecting the affected area for tenderness, changes in range of motion, neurologic deficit as well as other potential conditions, such as infection or fractures. In some cases, x-rays and/or MRI may also be used to obtain a better view of the discs.
Sometimes a myelogram, in which dye is injected around the spinal cord or nerve roots, and CT scans are performed to visualize the injured area.
Treatment
The most effective treatment for myelopathy is usually surgery. That is the only way to decompress the spinal canal, prevent further progression of the myelopathy and provide some relief from the symptoms. There are several procedures that are used to treat myelopathy, depending upon its location, the alignment of the spine, and other considerations.
Some of the options are:
- Laminectomy: In this procedure, a small section of bone that covers the back of the spinal cord, called the lamina, is removed to relieve the compression. It is most commonly performed on the vertebra in either the neck or the lower back.
- Laminoplasty: This surgery expands the spinal canal by removing any thickened ligament and elevating the lamina. The lamina are typically maintained in a more open position using titanium plates to hold them in place.
- Discectomy: A procedure in which a herniated disk is removed to relieve pressure on the nerves, a discectomy also involves a laminectomy to allow access to the troublesome disk. Microdiscectomy is a variation of this employing microscopes to magnify the section of spine and allow for a smaller incision and less damage to the rest of the area.
- Corpectomy: When corpectomy is performed, the damaged part of the vertebra and adjacent discs are removed from the spinal column. A bone graft and sometimes titanium plates and screws are incorporated into the spine to enhance support.
Contact our office to learn more about myelopathy or to schedule a consultation, where our surgeons at NYC Surgical can come up with a custom tailored plan for you.
