Myelopathy

What Is Myelopathy?

Myelopathy is an injury to the spinal cord caused by severe compression that may be a result of spinal stenosis, disc degeneration, disc herniation, autoimmune disorders or other trauma. When any part of the spinal cord is compressed, it causes nerve dysfunction along the spinal cord resulting in pain, loss of balance and coordination and numbness in the area around the compression point. Myelopathy can occur in any area along the spinal cord. Types of myelopathy include:

• Cervical myelopathy:  Myelopathy that occurs in the neck.
• Thoracic myelopathy: Myelopathy that occurs in the mid region of the spine.
• Lumbar myelopathy: Not as common as cervical or thoracic, lumbar myelopathy occurs in the lower region of the spine.

If left untreated, myelopathy can lead to permanent spinal cord injury and nerve damage.

Symptoms of Myelopathy

When the spinal cord is compressed or injured, it may cause a loss of sensation, loss of function, and pain or discomfort in the area at or below the compression point. Symptoms of myelopathy can vary based on where it occurs in the spine.

Myelopathy symptoms may include:

• Pain in the lower back, neck, arm or leg
• Tingling, numbness or weakness 
• Decreased fine motor skills, balance, and coordination
• Abnormal or increased reflexes in extremities
• Difficulty walking
• Loss of bowel or bladder function
  
   

Causes of Myelopathy

Myelopathy is the result of compression of the spinal cord and nerve roots caused by inflammation, arthritis, bone spurs and spinal degeneration due to aging. Myelopathy can also take an acute form or result from a spine deformity at birth.

Common causes of myelopathy are:

• Degenerative spinal conditions, such as spinal stenosis
• Central disc herniations
• Autoimmune disorders, such as rheumatoid arthritis
• Abnormalities, such as tumors, cysts, hernias, and hematomas
• Spinal injury or infection
• Inflammatory disease
• Radiation therapy
• Neurological disorders

Diagnosis of Myelopathy

A careful physical exam and a review of medical history is always the first step in diagnosing myelopathy. Myelopathy symptoms are not unique to this condition. Diagnostic tests your doctor may include are:

• A spine X-ray to rule out other causes of back or neck pain
• Spine MRI or spine CT, to show areas of pressure on the spinal canal
• Myelography, to determine location and presence of abnormalities of the spinal cord
• Electromyogram, to determine the exact nerve root that is involved

In many cases, a myelopathy diagnosis may be an indicator of another underlying condition related to the spinal cord.

Treatment at Penn

Treatment for myelopathy depends on the causes and other underlying conditions. Your treatment team will create an individualized treatment plan to help relieve symptoms and slow down progression. This may involve non-surgical treatment, surgery or a combination of both. 

Nonsurgical treatments may include:

• Physical therapy and exercise
• Bracing
• Taking non-steroidal anti-inflammatory drugs (NSAIDs)
• Interventional techniques such as nerve blocks (spinal injections)
• Epidural injections in the lumbar and cervical spine
• Activity modification

Your healthcare team will determine whether surgical treatment is necessary to remove any abnormalities and to relieve pressure on the spinal cord. Penn spine surgeons are highly experienced in performing the latest surgical techniques for the treatment of myelopathy. 

Surgical treatment for myelopathy includes:

• Spinal decompression surgery
• Discectomy
• Laminectomy
• Spinal Fusion
• Foraminotomy
• Disc replacement surgery

Penn Programs & Services for Myelopathy