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Myelopathy

Do you have nagging stiffness in your neck? Aching in your neck, arm or shoulder? Weakness or stiffness in the legs? Electric shock-like sensation down your spine when you flex your neck forward? These can be signs of a serious spine condition known as myelopathy.

Myelopathy is compression of the spinal cord. People often confuse it with other spinal conditions such as spinal stenosis or radiculopathy. Spinal stenosis describes the narrowing of the spinal canal (which can lead to myelopathy) and radiculopathy describes irritation of the nerve roots as they leave the spinal cord or cross the intervertebral disc. But myelopathy describes compromise of the spinal cord itself.

Myelopathy can occur in any region of the spine, but is most common in the cervical spine (neck).

Symptoms of myelopathy

 

Myelopathy is typically a symptom of a spinal condition such as stenosis, spondylosis, or a herniated disc. The most common form of myelopathy is known as Cervical Spondylotic Myelopathy. This form of myelopathy occurs in the cervical spine (neck) and is caused by spondylosis (spinal arthritis). Thoracic (upper back) myelopathy is less common, but can cause similar symptoms. Lumbar (lower back) myelopathy is rare.

 

People with myelopathy may experience:

  • Stiffness or weakness in the legs (the most common symptom)
  • Persistent neck stiffness
  • Aching in the neck, arm and shoulder
  • Numbness and tingling in the hands
  • Weakness/clumsiness in the hands
  • Problems with balance or walking
  • Subtle changes in bowel or bladder function
  • Electric-shock sensation down the spine when the neck is flexed forward
  • Weakness, muscle atrophy and cramping in the lower extremities (lumbar myelopathy)

 

Causes of myelopathy

A number of changes in the spine can create compression of the spinal cord, especially when they are left untreated for a long time. Bulging or herniated discs, bone spurs (Osteophytes), spinal trauma, spinal arthritis (spondylosis), tumors or other abnormal growths are common causes of myelopathy.

Congenital deformities, inflammatory diseases and diabetes can also cause myelopathy, as can spinal infection, radiation therapy or neurological disorders.

 

Treatment for myelopathy

First of all, it is important to ascertain whether your symptoms are caused by myelopathy and not something else. Dr. Baig will use imaging and electrodiagnostic tests in conjunction with a thorough physical examination to rule out less serious conditions that could be causing your symptoms. While we never want to frighten patients, myelopathy will only worsen over time. It is important to get treatment early on.

Mild myelopathy may be treated with medication, bracing and physiotherapy. These treatments can help deal with pain and increase mobility, but they do not treat the root cause of the problem– tissue pressing against the spinal nerves.

In most cases of myelopathy, surgery will eventually be required. Depending on which structures are pressing against the nerves, Dr. Baig will use the appropriate decompression surgery to remove the encroaching tissue and create space in the spinal canal.

The most common surgery for myelopathy is laminectomy. Dr. Baig is skilled and experienced in the most advanced and least invasive forms of decompression and spinal fusion surgery available, and will only perform surgery if he’s fully confident it will bring relief.