Myelopathy is any disease process that affects the spinal cord. When this effect in the spinal cord is due to trauma, it is known as a spinal cord injury. The clinical syndrome that results from a disorder in the spinal cord that disrupts or interrupts the normal transmission of the neural signals is known as a “myelopathy”.
There are many causes of cervical myelopathy; anything that interrupts the normal flow of neural impulses through the spinal cord may cause a clinical myelopathy. Some of the causes are trauma, viral processes, inflammatory or autoimmune disorders, tumor, or degenerative processes including spondylosis and intervertebral disc herniation.
Symptoms of Myelopathy depend on the level(s) of the spinal cord that are involved and pattern of involvement. Numbness of the hands, weakness of the arms and hands, leg stiffness, loss of balance, decreased strength and urinary urgency are all common symptoms of Myelopathy.
Transcranial Magnetic Stimulation (TMS), is a neurophysiological method that allows the measurement of time required for a neural impulse to cross pyramidal tracts. TMS aids physicians to determine whether myelopathy exists, and where it is located within the spinal cord.
Surgery may be required to decompress the spinal canal. If the patient also has Radiculopathy, conservative treatment like change in daily activity and exercises for cervical stenosis may help relieve arm pain.
The key to the treatment of cmyelopathy is to remove the pressure from the spinal cord. The surgery is performed to prevent the progression of symptoms; clinical improvement may or may not occur. You will need to discuss your prognosis with your Neurosurgeon prior to making a decision to have surgery.
Surgical procedures to decompress the spinal cord include approaches from the front of the neck (anterior cervical discectomy and fusion, anterior cervical corpectomy), from the back of the neck (cervical laminectomy, cervical laminectomy and fusion, cervical laminoplasty) and combined procedures in which both an anterior and a posterior approach are used. The exact procedure performed is based partly on the location of the stenosis and the overall alignment of the cervical spine, but many factors are considered in the decision.