Myelopathy

Overview

Myelopathy is a condition that describes compression of the spinal cord. Spinal cord compression can occur in the neck as well as in the thoracic region.

Symptoms

Symptoms associated with spinal cord compression can involve neurologic symptoms such as pain, numbness, tingling, weakness, difficulty walking and lack of coordination of the arms. Cervical myelopathy can wax and wane over time and there can be periods of improvement as well as periods of deterioration. It can be a slowly progressive disorder.

Quick development of cervical myelopathy can occur in younger patients due to a disc herniation or injury to the neck. Patients may often describe an electrical sensation shooting down the arms and throughout the upper and mid to lower back often referred to Lhermitte’s phenomenon.

Diagnosis involves a physical evaluation, imaging studies which may include a MRI of the cervical spine and possibly an EMG/nerve conduction study.

Treatment

Simple treatment such as medication, activity modification and physical therapy can provide some relief but since there is spinal cord compression it is best to consider surgical decompression especially if your activity levels are moderate to high. Surgery will give the spinal cord adequate room so it is not at high risk for injury.

Surgery for cervical myelopathy carries a greater risk than other types of cervical spine surgery since the spinal cord is compressed. It can involve anterior and/or posterior surgery on the cervical spine. The results of surgery over the long term are good to excellent. Depending on the age of the patient a decompression and fusion is typically the most common type of surgery for cervical myelopathy. There are also other procedures such as a cervical laminoplasty which can decompress the spinal cord in younger patients without having to do a fusion.