Myelopathy - Cervical, Thoracic & Lumbar
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.
At Aptiva Health, we offer same-day and walk-in appointments for spine injuries and conditions to evaluate, diagnose, and make the appropriate referral for additional treatment based upon your specific spine injury or condition. We treat spine injuries and conditions in our Spine, Pain Management, General Medicine, Orthopedics, and Physical Therapy departments.
Cervical Myelopathy
CSM, or Cervical (concerning the neck) Spondylotic (“wear and tear” arthritis of the spine) Myelopathy (injury to the spinal cord) is a common spinal cord disorder. It results from degenerative changes in the spinal column which reduce the space for the spinal cord and thus cause compression and hence a spinal cord injury.
The disease processes that lead to CSM can therefore be thought of in two phases:
1) ‘Spondylosis’ or degeneration of the spinal column – the wear and tear arthritis changes that cause the injury.
2) ‘Myelopathy’ or damage of the spinal cord – the reaction of the spinal cord to compression.
3) Evolution of the Disease – the response of the spinal cord to compression appears to differ from one person to the next, meaning that the course of the disease varies.
symptoms
There are many different symptoms of CSM and they are often mistaken for the signs of old age.
difficulty using their hands – dropping things, struggling to do up buttons etc.
difficulty using their legs – stiffness, unbalanced, changes in walking, falls etc.
changes in feelings and sensation – numbness, pins and needles etc.
difficulty passing urine and/or incontinence
pain
problems with mood and sleep
diagnosis
Diagnosis of CSM requires a thorough physical examination by a spine specialist at Aptiva Health. In addition to a comprehensive physical examination, your spine specialist will also utilize advanced imaging techniques such as x-ray, MRI, and EMG to effectively diagnose CSM.
Treatment
Treatment for CSM depends on the causes and other underlying conditions. The Aptiva Health Spine team will create an individualized treatment plan to help relieve symptoms and slow down progression. These treatment options may involve non-surgical treatment, surgery or a combination of both.
Non-surgical treatments may include:
Bracing
Taking non-steroidal anti-inflammatory drugs (NSAIDs)
Interventional techniques such as nerve blocks (spinal injections)
Activity modification
The Aptiva Health Spine Team will determine whether surgical treatment is necessary to remove any abnormalities and to relieve pressure on the spinal cord. Our Spine Team at Aptiva Health is highly experienced in performing the latest surgical techniques for the treatment of myelopathy.
Surgical treatment for myelopathy includes:
Spinal decompression surgery
Foraminotomy
Thoracic Myelopathy
As with cervical myelopathy, thoracic (mid-back) myelopathy is an injury that occurs due to severe compression of the spinal cord. Spinal cord compression of the thoracic spine may result from trauma, congenital stenosis, degenerative disc disease, herniated discs, or other disorders.
causes
The potential causes of thoracic myelopathy include:
Bone spur
Cyst or hematoma in the spine
Degenerative spine conditions, such as spinal stenosis (narrowing of the bones of the spine that compresses the spinal nerves)
Rheumatoid arthritis in the spine
Spinal injury or infection
Spinal tumor, including bone cancer
symptoms
Signs and symptoms of thoracic myelopathy include:
Difficulty with coordination
Pain in the neck, arm, leg or lower back
Tingling, numbness or weakness
Trouble keeping your balance
Trouble walking
Trouble with fine motor skills, such as holding a pen to write or using a zipper
Urinary or stool incontinence
diagnosis
Diagnosis of thoracic myelopathy requires a thorough physical examination by a spine specialist at Aptiva Health. In addition to a comprehensive physical examination, your spine specialist will also utilize advanced imaging techniques such as x-ray, MRI, and EMG to effectively diagnose thoracic spine myelopathy.
treatment
Treatment for thoracic myelopathy depends on the causes and other underlying conditions. The Aptiva Health Spine team will create an individualized treatment plan to help relieve symptoms and slow down progression. These treatment options may involve non-surgical treatment, surgery or a combination of both.
Non-surgical treatments may include:
Bracing
Taking non-steroidal anti-inflammatory drugs (NSAIDs)
Interventional techniques such as nerve blocks (spinal injections)
Activity modification
The Aptiva Health Spine Team will determine whether surgical treatment is necessary to remove any abnormalities and to relieve pressure on the spinal cord. Our Spine Team at Aptiva Health is highly experienced in performing the latest surgical techniques for the treatment of myelopathy.
Surgical treatment for myelopathy includes:
Spinal decompression surgery. In this procedure, your spine specialist removes the cause of your thoracic myelopathy, such as a bone spur or herniated disc.
Laminoplasty. In this treatment for more advanced types of thoracic myelopathy, your spine specialist widens the space where your spinal cord passes. This procedure helps to relieve pain and other symptoms associated with thoracic myelopathy.
Lumbar Myelopathy
Lumbar myelopathy is not as common as cervical or thoracic myelopathy because in most people, the spinal cord ends in the top section of the lumbar spine. However, if the spinal cord is low-lying or tethered, it can be affected by lumbar myelopathy.
causes
The potential causes of thoracic myelopathy include:
Bone spur
Cyst or hematoma in the spine
Degenerative spine conditions, such as spinal stenosis (narrowing of the bones of the spine that compresses the spinal nerves)
Rheumatoid arthritis in the spine
Spinal injury or infection
Spinal tumor, including bone cancer
symptoms
Signs and symptoms of thoracic myelopathy include:
Difficulty with coordination
Pain in the low back
Tingling, numbness or weakness
Trouble keeping your balance
Trouble walking
Trouble with fine motor skills involving the lower extremities
Urinary or stool incontinence
diagnosis
Diagnosis of lumbar myelopathy requires a thorough physical examination by a spine specialist at Aptiva Health. In addition to a comprehensive physical examination, your spine specialist will also utilize advanced imaging techniques such as x-ray, MRI, and EMG to effectively diagnose lumbar spine myelopathy.
treatment
Treatment for lumbar myelopathy depends on the causes and other underlying conditions. The Aptiva Health Spine team will create an individualized treatment plan to help relieve symptoms and slow down progression. These treatment options may involve non-surgical treatment, surgery or a combination of both.
Non-surgical treatments may include:
Bracing
Taking non-steroidal anti-inflammatory drugs (NSAIDs)
Interventional techniques such as nerve blocks (spinal injections)
Activity modification
The Aptiva Health Spine Team will determine whether surgical treatment is necessary to remove any abnormalities and to relieve pressure on the spinal cord. Our Spine Team at Aptiva Health is highly experienced in performing the latest surgical techniques for the treatment of myelopathy.
Surgical treatment for myelopathy includes:
Lumbar Spine decompression surgery. In this procedure, your spine specialist removes the cause of your thoracic myelopathy, such as a bone spur or herniated disc.
Lumbar spine decompression with fusion (MAS TLIF). Lumbar interbody fusion is a surgical technique that attempts to eliminate instability in the back. A MAS® TLIF achieves this by using a less invasive approach to fuse one or more vertebrae together to reduce their motion. In a MAS® TLIF procedure, rather than starting from the middle of the back and spreading the muscles to the sides like in a traditional back surgery, the MAS® TLIF approach starts off to one side of the back and splits (rather than cuts) the back muscles in one direction. This allows the surgeon to make a smaller incision with less muscle injury, which may result in less postoperative pain and a quicker recovery. This approach has proven to reduce blood loss, minimize scarring, reduce length of hospital stay, and allow for patients to recover quicker than conventional lumbar fusions. At Aptiva Health, our orthopedic spine surgeons specialize in the MAS® TLIF procedure.