Myelopathy
Understanding Myelopathy
By Neurosurgery Singapore
What is Myelopathy?
Myelopathy refers to spinal cord dysfunction caused by severe compression, which can result from trauma, congenital stenosis, degenerative diseases, or disc herniation. The spinal cord is a bundle of nerves enclosed within the vertebral column, running nearly the entire length of the spine. When any part of the spinal cord experiences compression or constriction, it leads to myelopathy, producing a range of neurological symptoms.
There are three main types for this condition, each named based on the area of the spine affected:
- Cervical myelopathy: This occurs when the spinal cord is compressed in the neck (cervical spine). The most common form is degenerative cervical myelopathy (also called cervical spondylotic myelopathy), which results from age-related changes in the spine.
- Thoracic myelopathy: This involves compression in the middle of the spine, specifically in the mid to upper back (thoracic spine).
- Lumbar myelopathy: This occurs when compression affects the lower back, or lumbar spine, typically around the area near the buttocks.
What are some symptoms of Myelopathy?
Symptoms of this condition can manifest in the area of the spine affected and may radiate to other parts of the body, depending on the location of the compression. Common signs may include:
- Pain in the neck, lower back, arms, or legs (though not always present)
- Tingling or numbness
- Weakness
- Reduced motor skills (such as difficulty buttoning shirts, holding utensils, or dropping objects)
- Abnormal or exaggerated reflexes
- Difficulty walking and poor balance
- Loss of bowel or bladder control
“Myelopathy refers to a condition known as spinal cord compression, while radiculopathy occurs when a nerve root (but not the cord itself) becomes compressed.”
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What types of diagnosis?
We highly recommend seeking professional help instead of self diagnosis in order to identify the source of the issue and to receive faster recovery.
To diagnose this condition, our spine specialist may recommend one or more of the following tests:
- Imaging tests – X-rays, MRIs, or CT scans to provide detailed views of the spine.
- Myelogram – A specialized imaging test that uses contrast dye to highlight the relationship between bones and soft tissues in the spine.
- Nerve function tests – Electromyography (EMG) or evoked potentials to evaluate how effectively the brain and body transmit nerve signals.”
Possible Myelopathy treatment methods?
Myelopathy treatment depends on its underlying cause. In some cases, the damage may be irreversible, so treatment focuses on symptom relief and slowing the progression of the condition. Therefore, the recommended treatment will depend on your symptoms, age, overall health, and the severity of the condition.
Non-invasive treatment
Nonsurgical treatments for this condition may include bracing, physical therapy, and medication. These options are typically recommended for mild cases to help reduce pain and improve daily function.
However, nonsurgical treatments do not relieve spinal cord compression. Symptoms may continue to progress—usually gradually, but sometimes suddenly. If you notice worsening symptoms, consult your doctor promptly. Some progression may become irreversible, making early intervention crucial to slowing or preventing further damage.
Surgical Myelopathy treatment
Spinal decompression surgery is a common treatment for this condition It is designed to relieve pressure on the spinal cord. Surgery may also be used to remove bone spurs or herniated discs if they are contributing to the condition.
For advanced condition caused by stenosis, a doctor may recommend laminoplasty, a motion-sparing procedure that enlarges the spinal canal while preserving flexibility at the compression site. However, not all patients are candidates for laminoplasty. An alternative is decompression and spinal fusion, which can be performed anteriorly (from the front) or posteriorly (from the back). Spinal fusion stabilizes the spine by permanently joining vertebrae, eliminating movement in the affected area.
Minimally invasive spine surgery may also be an option, offering potential benefits such as reduced complication risks and a faster recovery compared to traditional open surgery.
Our team has the expertise and treatments to support a fast and effective recovery.
