Where some type of injury causes severe compression or constriction of the spinal cord, this is referred to as myelopathy. 'Myelo' from the Greek refers to the spinal cord and 'pathy' is the Greek word for 'suffering'.
Common causes of myelopathy include degenerative disc disease, spinal stenosis and herniated disc. The condition can affect any section of the spinal cord – from the cervical section at the top to the thoracic section in the middle to the lumbar region at the base of the spine.
The most common type of myelopathy is cervical myelopathy, with lumbar myelopathy being reasonably rare, as the spinal cord terminates above this section in most people, only extending below this in a small number of people. Thoracic myelopathy, affecting the mid-section of the spine, is generally caused by some form of injury, or the growth of an osteophyte (a 'bone spur').
There is another similarly named condition affecting the muscles called 'myopathy', but the two are not related. It is also different from radiculopathy, which is a condition that relates to the nerve roots ('radiculo-' means 'root'), not the spinal cord itself.
The direct cause is anything that places some form of pressure on the spinal cord. This can include…
- Disc herniation.
- Spinal stenosis.
- Other growths near or on the spine e.g. cysts, tumours (cancerous or benign), hernias and heamatoma.
- Injury to / infection of the spine.
- Rheumatoid arthritis and other autoimmune conditions.
- Neurological conditions.
Myelopathy can also be caused by radiation treatment.
- Symptoms of myelopathy include…
- Pain affecting the lower back, or the neck, arms or legs.
- Loss of control or sensation relating to the bladder and/or bowels (including incontinence and faecal incontinence).
- Problems with coordination and balance.
- Difficulty walking normally.
- Muscle weakness, resulting in loss of dexterity ('fine motor skills') and grip strength – this can prevent everyday activities such as writing and buttoning up a shirt.
- Reduction in sensation in some parts of the body, especially the arms, legs, hands and feet.
Tests / Diagnosis
Usually, an MRI scan will suggest this diagnosis.
Myelopathy does share the same set of symptoms as several other conditions, so a critical part of the diagnostic process is to eliminate other possible causes. X-rays will determine if there is another possible cause of the symptoms and an MRI or CT scan will show whether there is any spinal stenosis present.
A myelography ('myelogram') may be recommended – this is essentially a CT scan using a contrast dye to highlight any issues in the spinal canal. A nerve conduction study may also be recommended to check if the nerves are functioning correctly.