When you bend your elbow and hold it for a while, your arm starts to feel a little numb, right? But as soon as you straighten your arm again, the numbness gradually goes away. But imagine, what if the numbness persists? That's what happens in a condition called Myelopathy. This is something to be concerned about. Let's talk about it simply.
What is Myelopathy? Let's understand it simply.
Simply put, Myelopathy is when the spinal cord inside our spine is compressed for some reason. Think of our spinal cord as the main 'cable' that carries messages from our brain to every other part of our body. It runs safely inside our spine.
So what happens if this most important 'cable', the spinal cord, is pinched somewhere? That message is interrupted. That's when things like pain, numbness, a feeling of numbness in parts of the body, and inability to move properly start to happen. Even everyday tasks like holding a pen properly or buttoning a shirt can be difficult.
Are there main types of myelopathy?
Yes, Myelopathy can be divided into three main types depending on where the spinal cord is compressed.
| Type of Myelopathy | Description |
|---|---|
| Cervical Myelopathy | This is the most common type. It occurs when the spinal cord is compressed in the cervical spine . This condition is often caused by degenerative changes in the spine with age. |
| Thoracic Myelopathy | Here, the compression occurs in the middle of the back, that is, in the thoracic spine behind the chest . |
| Lumbar Myelopathy | In this case, the pressure is on the lower back (lumbar spine) . |
How serious should this situation be taken?
This is not a condition to just ignore. If left untreated, this condition can worsen over time.
If the compression of the spinal cord continues, it can cause permanent damage to the nerves. If that happens, the symptoms may not be reversible. In some severe cases, this condition can even lead to serious complications such as paralysis .
Therefore, if you suspect that you have any of these symptoms, the best thing to do is to see a doctor immediately for advice. The earlier you are diagnosed, the more likely you are to get good treatment results.
What are the main symptoms of myelopathy?
Because different parts of the spinal cord control different parts of the body, symptoms can vary depending on where the compression occurs. However, there are a few common symptoms that can be seen.
| Symptom | Description |
|---|---|
| Pain | Neck or back pain. |
| Numbness, lifelessness | Numbness, tingling, or weakness in the arms, hands, legs, or feet. |
| Difficulty with delicate tasks | Difficulty performing fine motor skills such as buttoning a shirt, writing with a pen, or using a wrench. |
| Problems with walking and balance | Feeling of loss of balance, clumsiness when walking. |
| Problems with bowel control | In some severe cases, there may be difficulty controlling bowel and bladder control. |
What are the causes of myelopathy?
There are many things that can cause spinal cord compression.
- Herniated disk: A jelly-like disk between two vertebrae can bulge out and press on the spinal cord.
- Spondylosis: Due to the natural wear and tear and changes that occur in the spine as we age.
- Spinal stenosis: Narrowing of the spinal canal due to various reasons.
- Traumatic injury: An injury to the spine from something like a fall or a car accident.
- Infection and inflammation: Infectious conditions affecting the spine.
- Tumor: A cancerous or other lump that forms in or around the spine.
- Neurodegenerative diseases: Conditions such as Parkinson's disease or ALS.
Who is most at risk of developing this?
Myelopathy can occur at any age. However, the type that occurs due to age-related changes in the spine is most common in people over the age of 40. Also, research has shown that men are more likely to develop this condition than women.
How does a doctor find this?
When you go to see a doctor, he will first ask you in detail about your symptoms, how they started, and how long you've had them. Then he will examine you.
- Physical exam: Your body movements and pain areas are checked.
- Neurological exam: This will check your reflexes, muscle strength, and sensation.
After these tests, it is recommended that certain tests be performed to confirm the diagnosis and determine the exact cause of the rash.
- Imaging tests: Tests that take pictures of the spine. For example, an X-ray, MRI scan, or CT scan . These can clearly see the condition of the spine, discs, and spinal cord.
- Myelogram: A special substance (contrast dye) is injected into the spinal cord and an X-ray or CT scan is taken. This can clearly identify areas of compression of the spinal cord and nerves.
- Nerve function tests: Tests that measure the speed at which messages flow between the brain and the body. Electromyography (EMG) is one such test.
What are the treatments for myelopathy?
Treatment depends on the severity of your symptoms, the location of the spinal cord compression, and the cause. What works for one person may not work for another. There are two main types of treatment: nonsurgical and surgical.
Non-surgical treatments
These treatments only control symptoms. They do not relieve pressure on the spinal cord. If your symptoms are not severe, or while you are waiting for surgery, your doctor may recommend these treatments.
- Wearing a brace: A brace worn around the neck or back can limit movement in that area and reduce pain.
- Physical therapy: Specific exercises and treatments are recommended to strengthen muscles, increase flexibility, and reduce pain.
- Medications: Things like painkillers and anti-inflammatory drugs (corticosteroids) can help control symptoms.
Surgery
In myelopathy, the best way to relieve pressure on the spinal cord and give it freedom is surgery.
If symptoms are severe, getting worse day by day, or if non-surgical treatments do not help, your doctor may recommend surgery.
This is done using a type of surgery called spinal decompression surgery . Depending on the cause of the compression, the surgeon uses different techniques. Some examples are:
- ACDF surgery
- Diskectomy (removal of a disc)
- Disk replacement (insertion of an artificial disk)
- Laminectomy
- Laminoplasty
- Spinal fusion
Before surgery, your surgeon will clearly explain the advantages, disadvantages, and risks to you.
Is there a way to prevent myelopathy?
It's not always possible to prevent this, especially when it comes to conditions that occur as we age.
However, taking care of our spine can reduce the risk of some causes.
- When lifting a load, lift it properly: When lifting a load, practice lifting it with your knees bent and your back straight, without bending your back.
- Maintain good posture: Keep your back straight when sitting and standing.
- Exercise regularly: Engage in exercises that strengthen your back and abdominal muscles.
When should I see a doctor?
If you have the following symptoms, do not ignore them and see a doctor immediately.
| Seek medical advice immediately. | |
|---|---|
| A change in the way you walk, loss of balance, or a tendency to stumble | |
| New or worsening pain in the neck or back | |
| Numbness, tingling, or weakness in the hands, fingers, feet, or toes | |
Questions to ask your doctor
When you find out that you have this condition, you may have many questions in your mind. Ask your doctor about these things.
- Why is my spinal cord compressed?
- What is the best treatment you recommend for me?
- Are there any side effects of these treatments?
- Will I need surgery?
- How long does it take to fully recover after surgery?
- What are the things I should not do or avoid?
The spinal cord is a very important part of our body. Even a small amount of pressure on it can affect the functioning of our entire body. Therefore, it is very important to be aware of the symptoms and seek medical advice quickly if necessary.
Take-Home Message
- Myelopathy is a serious condition caused by compression of the spinal cord. This should not be ignored.
- If you have symptoms such as numbness in your limbs, weakness, or difficulty walking along with neck or back pain, see a doctor immediately.
- Early diagnosis and treatment can prevent permanent nerve damage.
- There are treatment options (surgical and non-surgical), and your doctor will determine the most appropriate treatment for you.
- Taking care of your back when lifting weights and during daily activities can reduce some of the risks.
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