What is Myelopathy?
What is Myelopathy?Myelopathy is a spine disorder from severe spine compression, usually caused by age-related degenerative changes, disc herniation, traumatic injury, spinal infection, or other conditions. Reduction of the spine can damage the spinal cord, or the nerves that run from your brain to your body, and result in it being unable to function correctly. Myelopathy encompasses various symptoms, including pain, weakness, numbness, loss of hand dexterity (e.g., dropping items), loss of balance, and inability to move correctly. It typically manifests in your back, neck, arms, hands, or legs.
Differences between myelopathy, radiculopathy, and myopathy
Myelopathy is not to be confused with radiculopathy or myopathy, which are two different conditions that can result in pain or loss of movement. Despite overlapping symptoms, the three conditions are unique, caused by different underlying processes, and require other treatments.
- Myelopathy is a spine disorder resulting from spinal cord compression, which can cause pain, weakness, numbness, loss of hand dexterity, loss of balance, or dysfunction in physical movement.
- Radiculopathy is caused by the compression of a spinal nerve root or a pinched nerve in your spine. Radiculopathy can be caused by disc herniation or spondylosis (i.e., degenerative arthritis) and can lead to symptoms like radiating pain into your arms and legs and weakness, tingling or numbness in your arms or legs.
- Myopathy is an umbrella term encompassing diseases that impact the muscles connected to your bones. The muscular disorder affects muscle fibers, resulting in muscle weakness and difficulty performing daily movements and activities.
Myelopathy is different from radiculopathy in that it affects the whole spinal cord, whereas radiculopathy is limited to the compression of certain nerve roots and not the spinal cord itself. Myelopathy is also distinct from myopathy in that the latter is a muscular disorder that impacts muscle fibers rather than the spinal cord.
Types of Myelopathy
TypesThere are three main types of myelopathy, depending on what part of the spine is impacted by the disease. Those include:
- Cervical myelopathy refers to compression in the spinal cord in your neck or cervical spine. Cervical myelopathy can lead to difficulties with fine motor skills or walking, weakness, numbness, tingling in the upper or lower extremities, or issues with urination. Cervical myelopathy is the most common form of myelopathy. Typically, the condition is treated with spinal decompression surgery, but it may also be treated with physical therapy and medication.
- Thoracic myelopathy affects the middle of your spinal cord, located in your mid and upper back around your rib cage. Typically, this condition is treated with spinal decompression surgery, but it can also be handled with physical therapy and medication.
- Lumbar myelopathy. The spinal cord typically ends at the L1-2 level. Below this level, any compression of the spinal canal would result in radiculopathy or pinched nerves.
Signs & Symptoms of Myelopathy
SymptomsSymptoms of myelopathy may manifest in the part of your spine affected and travel to other parts of your body. Loss of sensation, function, pain, and discomfort may occur in the area of the compressed point in the spine or below it. Symptoms may vary depending on where the compression is in the spine. Signs of myelopathy include:
- Pain in the lower back, neck, arm, or leg (though not a cardinal feature)
- Tingling
- Numbness
- Weakness
- Decreased motor skills (difficulty with buttoning shirts, holding silverware, or dropping items)
- Abnormal or increased reflexes
- Difficulty walking, poor balance
- Loss of bowel or bladder function
If you’re experiencing symptoms of myelopathy, NewYork-Presbyterian is here to help. Our specialists can help diagnose your condition and provide you with the best treatment options tailored to you.
What Causes Myelopathy?
CausesAnything that results in spinal cord compression can cause myelopathy, from degenerative changes and injuries to inflammation. While injuries typically cause acute myelopathy, general myelopathy is most commonly caused by degeneration of the spine over the course of a long time from aging and wear and tear, such as spondylosis. Causes of myelopathy include:
- Disc herniations
- Arthritis
- Bone spurs
- Spinal degeneration from aging
- Spinal stenosis
- Autoimmune disorders
- Spinal injury
- Infection
- Spinal tumor
- Radiation therapy
- Inflammation
- Nutritional deficiencies
Risk Factors
Risk FactorsTypically, age is the main risk factor associated with myelopathy, as the natural wear and tear of your spine throughout your life can result in the disease. But other lifestyle factors can play a role in developing myelopathy, such as smoking, drinking, obesity, or the type of physical activities you engage in for work or sport. While engaging in high-intensity sports can increase your risk of spinal compression, inactivity or being sedentary can also increase your risk. Myelopathy risk factors include:
- Age
- Smoking
- Obesity
- High-intensity sports like football or gymnastics
- Inactive lifestyle
- Occupation, such as a manual labor job, can stress your back
- Alcohol
Complications
ComplicationsIf left untreated, myelopathy can lead to complications, as the disease can progress over time. You may experience neurological symptoms that impair your sense of balance, motor skills, or bladder function. Over time, myelopathy can lead to paralysis and even death. Myelopathy complications include:
- Loss of motor skills, dexterity, or bowel and bladder function
- Difficulty or inability to walk
- Requirement of an assistive device for ambulation/mobilization
- Lack of sensation
- Loss of sexual function
- Inability to work
- Paralysis
Prevention
PreventionWhile in some cases myelopathy can’t be prevented, you can make certain lifestyle changes to help lower the risk of developing it. For example, you may want to strengthen the muscles in your neck, back, and abdomen, as this can create sturdier protection around your spine. Prevention tips include:
- Maintaining a healthy lifestyle, including diet and exercise
- Staying at a healthy weight
- Lifting heavy objects properly to avoid damage to your spine
- Strengthening the core muscles in your back through yoga, pilates, planks, or other safe exercises
- Maintaining good posture
- Taking care of your neck and back to prevent strains, broken bones, or any acute injuries
- Quitting smoking, as smoking is a risk factor for disc degeneration
Trust NewYork-Presbyterian for Myelopathy Care
If you believe you may have signs of myelopathy, our team of specialists at NewYork-Presbyterian can guide you through a step-by-step process, from diagnosis to treatment, to help address the root causes of your condition. It’s important to seek treatment for myelopathy to prevent any further nerve damage and to help you return to your daily activities. Call us to make an appointment so we can connect you with the best care team for you.