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Myelopathy: An Overview

spine doctor, pain management

Myelopathy is a condition in which the front of the spinal cord becomes compressed, resulting in progressive deterioration. The disorder most commonly appears in the cervical (neck) area, and in rare instances can be present in the thoracic (torso) region. Myelopathy causes neck pain in greater than ten percent of people over the age of 55 who have spinal stenosis. In general, spinal cord disorders can be challenging to treat effectively due to their infrequent occurrence, and myelopathy is no exception.

Myelopathy can result from a variety factors, such as congenital deformities, normal wear and tear with aging, inflammation, and nutritional deficits. Spinal stenosis, disc herniation, bone spurs, spondylosis, and blunt penetration injuries can also trigger myelopathy.

Symptoms of myelopathy develop slowly over time, and include the following:

  • Neck stiffness, with pain on each side; grating and cracking
  • Weak and stiffness in the legs that change walking pattern and limits pace
  • Clumsiness in performing fine motor skills with hands
  • Arm numbness or dull ache
  • Stabbing sensation in arms, elbow, wrist, or fingers
  • Pain in shoulders
  • Inappropriately increased reflex response
  • Incontinence and loss of sensation

Pain associated with myelopathy may relate to facet joints, vertebrae, or spinal ligaments, muscles, or nerves.

A physician diagnoses myelopathy based on a review of medical history and physical examination that specifically assesses reflexes, muscle weakness, and muscle loss. MRI, X-Ray, EMG, and a CT scan with myelogram will help to verify the findings.

Treatment for myelopathy starts with regular physician check-ups, medication for pain and inflammation, and bracing for cervical support when needed. Physical therapy is implemented for exercise and manipulation once the pain is under control. Epidural steroid injections are the next step if conservative therapy is unsuccessful. Unfortunately, myelopathy rarely improves without surgery, and a decompressive procedure such as an anterior or posterior laminotomy with fusion is often necessary.

If you have been diagnosed with myelopathy and would like to find out about the treatment choices we offer, please call us at either our New Braunfels or Seguin offices.

 

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