Do you sometimes feel numb or lifeless in your arms and legs along with a sore neck or back? Do you sometimes feel like you're losing your balance when walking, or have difficulty doing delicate tasks, such as buttoning a shirt? If you have these symptoms, the cause may be more serious than you think. Today we're talking about a condition called ' myelopathy ' that causes these symptoms.
What is Myelopathy?
Simply put, myelopathy is a condition that occurs when our spinal cord is compressed . Think about it, the spinal cord is a very important nerve cable that runs from our brain all the way down our spine. It is like the main 'cable' of our body. Messages from the brain are carried to the entire body, including the limbs, and the body's sensations are carried back to the brain through this spinal cord. To protect this valuable 'cable', there is a covering made of bones, cartilage, and tissue around it, called the spinal canal .
When, for some reason, the space inside this spinal canal becomes narrowed and the spinal cord begins to compress, the communication of messages is disrupted. That's what we call myelopathy.
Many people confuse the two conditions myelopathy and myopathy . But the two are completely different. Myelopathy is a condition that affects the nerves in the spinal cord . Myopathy is a condition that affects the muscles .
Myelopathy is divided into several main types depending on where in the spinal cord it is affected.
| Type of myelopathy | Affected area |
|---|---|
| Cervical Myelopathy | Affecting the spinal cord in the neck area. (This is the most common type.) |
| Thoracic Myelopathy | At the thoracic level, meaning the spinal cord in the middle and upper back is affected. |
| Lumbar Myelopathy | Affecting the lower part of the spine. This is a very rare condition because the spinal cord does not normally run this low. |
What are the causes of myelopathy?
There are several reasons why the spinal cord can become compressed. Two of the main causes are conditions called arthritis and spondylosis . These are caused by the gradual wear and tear of our spine, or vertebrae, as we age. This wear and tear can change the shape of the bones and narrow the spinal canal. The condition that occurs especially in the neck is called Cervical Spondylotic Myelopathy .
In addition, there are other reasons:
- Bone spur: A small piece of bone can protrude from a vertebra and press on the spinal cord or the nerves that branch off of it.
- Accidents: Myelopathy can occur suddenly due to an injury to the spine, such as a fall or a car accident. We call this acute myelopathy .
- Other medical conditions: Neurodegenerative diseases such as rheumatoid arthritis , spinal tumors, or Parkinson's disease can also cause myelopathy to develop gradually over time. This is called chronic myelopathy .
What are the symptoms of myelopathy?
Symptoms of myelopathy develop gradually. Although they may be mild at first, they can increase over time. The main symptoms you may see are:
- Pain in the neck, back, arms, or legs.
- Feeling of numbness, burning, or loss of sensation in the limbs.
- Losing balance while walking, feeling like you're swaying.
- Difficulty coordinating body movements.
- Difficulty performing fine manual tasks, such as writing, buttoning a shirt, or tying shoelaces.
- Feeling of numbness and weakness in the arms and legs.
- As the disease progresses, you may experience uncontrolled urination and defecation .
If you have these symptoms, don't ignore them . It's important to seek medical advice immediately.
How do you accurately diagnose myelopathy?
When you go to see your doctor, the first thing he or she will do is listen to your symptoms and perform a physical exam. After that, they may recommend several tests to confirm the diagnosis and rule out other conditions.
| Medical examination | What is expected from it? |
|---|---|
| X-ray examination | Check for other problems such as fractures or fractures in the spine. |
| MRI scan (Magnetic Resonance Imaging) | This is the best test. You can clearly see everything, including the spinal cord, nerves, and discs between the vertebrae. You can find out exactly where the spinal cord is and how much it is compressed. |
| Myelography | This test is performed for people who cannot get into an MRI machine (for example, those with pacemakers). A special liquid (dye) is injected into the spine and real-time X-rays (fluoroscopy) are used to identify problematic areas in the spinal cord. |
| Electrical Tests | Tests like an electromyogram (EMG) check the function of nerves and how muscles respond to them. |
What are the treatments for myelopathy?
Treatment depends on the type of myelopathy you have, its cause, and the severity of your symptoms.
Non-Surgical Treatments
In the early stages or if the symptoms are not too severe, your doctor may recommend non-surgical treatments.
- Physical Therapy: These exercises help strengthen the muscles of the back and neck and reduce pressure on the spinal cord.
- Neck brace: This helps limit neck movement, reduce pain, and prevent the condition from getting worse.
- Medication: Painkillers such as NSAIDs (Non-steroidal anti-inflammatory drugs) are given to reduce pain and swelling. Sometimes, if the pain is severe, steroid injections are given directly to the affected area.
Surgical Treatments
If symptoms are severe, especially if there is loss of bladder or bowel control, or if something like a tumor or bone fragment needs to be removed, surgery is the best solution. Surgery can relieve pressure on the spinal cord and provide permanent relief.
| Name of the surgery | What simply happens |
|---|---|
| Laminectomy | A portion of the vertebral bone (lamina) that is causing compression of the spinal cord is removed, allowing the spinal cord to remain free. |
| Laminoplasty | Without completely removing the bone, a hinge is made on one side, creating a space like opening a door. This is done only for the neck bones. |
| Spinal Fusion | Two or more vertebrae are fixed together, stabilizing the spine. This greatly reduces pain. |
Recovery after treatment
The most important thing in the case of myelopathy is to recognize the disease early and start treatment . Because, if the spinal cord is severely compressed, irreversible damage can occur to the nerves. Therefore, even the movement of the limbs may be permanently lost. Therefore, if you have the symptoms mentioned in this article, do not be afraid, and see a doctor to find out about it. With early treatment, your quality of life can be maintained.
Take-Home Message
- Myelopathy is not a muscle problem, but a nerve problem caused by compression of the spinal cord.
- Don't ignore symptoms such as neck or back pain accompanied by numbness, weakness, difficulty walking, or difficulty performing fine manual tasks.
- If you have one or more of these symptoms, see a doctor as soon as possible for advice.
- Early diagnosis and treatment can prevent permanent nerve damage.
- Depending on the cause and severity, there are effective treatments ranging from exercise and medication to surgery.
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