Myelopathy is a condition that affects the spinal cord. It occurs where an injury or another condition (for example a disc prolapse, spinal stenosis or a degenerative condition) causes severe compression of the spinal cord. Any part of the spinal cord can be affected, although the neck (‘cervical’) region is the most common.
Surgery is the only available treatment for myelopathy in a procedure known as 'decompression surgery'. Myelopathy should not be confused with the similar sounding 'myopathy', which is a condition affecting the muscles. It is also distinct from radiculopathy which affects the nerve roots as they exit the spinal cord.
Myelopathy is categorised according to the part of the spinal cord that is affected...
- Cervical myelopathy affects the neck ('cervix' means 'neck' or 'neck-like' in Latin) - it is the most common type of the condition.
- Thoracic myelopathy affects the middle section of the spinal cord - this is most frequently caused by injury (including disc prolapse), or the growth of a bone spur.
- Lumbar myelopathy affects the lower spine - this is uncommon as in most people the spinal cord ends above this section, although in some people it may extend lower.
As described above, the main causes of myelopathy are…
- Spinal stenosis (Congenital narrowing within the spinal canal, meaning present from birth).
- Disc prolapse.
- Bone spurs.
Symptoms of myelopathy may include…
- Difficulties with walking and with balance.
- Loss of strength of grip and dexterity, general weakness, change of sensation in arms / hands / legs / feet (Sometimes, the arms are affected more than legs).
- Incontinence or loss of sensation of needing to go to the toilet (bladder and / or bowel).
- Pain in the distribution of the nerve root at the level of compression – Radiculopathy.
Tests / Diagnosis
Any indication of the symptoms outlined above in a medical examination may point to a diagnosis of myelopathy. A number of examination tests may be used together to determine the likelihood of a diagnosis of myelopathy. Presence of the condition is normally confirmed via an MRI (magnetic resonance imaging) scan. CT scans of the spine may also be helpful to plan treatment. When the diagnosis is not clear, nerve conduction studies and EMG may also be performed to exclude other possibilities.