Guide to Advanced Surgery for The Spine
Why Choose Cedars-Sinai Marina del Rey Hospital for Myelopathy Treatment?
Our spinal surgeons are highly skilled and trained in the diagnosis and surgical treatment of various spinal disorders, including myelopathy. Their vast experience helps in providing you the most effective treatment plan based on your symptoms, the severity of the disease, and your individual needs.
The term myelopathy refers to the chronic symptoms that result from severe spinal cord compression, which often occur due to traumatic injury, degenerative aging, changes of the spine, or spinal deformities that are present at birth. Myelopathy ranges in severity and usually occurs in people above the age of 50, as a result of wear and tear. The symptoms arise as the spinal canal narrows down, resulting in compression of the spinal cord and its nerves. The chronic pain caused by myelopathy is often described as shooting pain that radiates to the hands and arms, along with tingling numbness and difficulty walking or standing for a long time.
Myelopathy commonly occurs as a result of spinal stenosis, a condition in which the spinal cord, or the nerves located in the spinal canal, are compressed due to a degenerative condition. When a nerve in the spinal cord is pinched, causing extreme pain, the condition is called myelopathy. A nerve can become pinched for a variety of reasons, including:
- Bone spurs or roughness inside the spinal canal that irritate the nerve
- Getting trapped between bones, tendons, or ligaments
- Inflammation of the bones of the spine that may cause a narrowing of the canal through which the spinal cord runs
Surgical Procedures Performed at Cedars-Sinai Marina del Rey Hospital to Treat Myelopathy
A wide range of surgical treatment procedures is performed at Cedars-Sinai Marina del Rey Hospital to relieve spinal cord compression. The most appropriate spinal decompression procedure will be chosen depending on factors such as the level of the spinal cord that is affected, the severity of the symptoms, and a patient's general health. The surgical procedures commonly recommended to treat myelopathy include:
Corpectomy and Fusion »
Discectomy and Fusion »
Minimally Invasive Spinal Fusion
The spinal surgery experts at Cedars-Sinai Marina del Rey Hospital are also well versed in minimally invasive spinal surgeries (stabilization surgeries) to treat myelopathy. Stabilization surgeries are an effective option because they involve smaller incisions and minimal disruption of muscles, which allows for faster recovery time and fewer complications than traditional open surgery procedures. Stabilization surgeries are usually done on an outpatient basis, meaning the patient can return home on the day of the surgery.
Drugs and Other Treatments for Myelopathy
Milder forms of myelopathy can be initially treated with more conservative methods to relieve pain and discomfort while a patient decides on a surgical treatment. Medications, such as over-the-counter and prescription painkillers and anti-inflammatory drugs are some of the most common non-surgical options to reduce spinal pain. Other treatment options include epidural steroid injections, physical therapy, bracing, use of soft cervical collars, and activity modification.
Epidural Steroid Injection »
Physical Therapy »
Activity Modification »
Depending on the spinal segment that is affected, myelopathy is divided into three different types:
Lumbar Myelopathy »
Thoracic Myelopathy »
Cervical Myelopathy »
Symptoms of Myelopathy
Usually, spinal cord compression may lead to pain or discomfort accompanied by a loss of function and feeling at or near the site of injury.
The common symptoms of myelopathy include:
- Radiating type of pain in the neck, arms, legs, or lower back
- Tingling sensation or numbness in hands and arms
- Muscle weakness in the hands and arms, leading to difficulty holding objects
- Difficulty writing, buttoning clothes and walking
- Abnormal reflexes in limbs and trouble in maintaining balance and coordination
Diagnosis of Myelopathy
In order to make an accurate diagnosis of myelopathy, a doctor will perform a careful physical examination and order certain tests and scans. During the physical examination, the neck, hands, shoulders, and legs will be checked for abnormal reflexes, numbness or weakness, imbalance, and muscle atrophy.
The diagnostic tests that may be ordered include:
- X-ray: An X-ray is done to check whether the vertebrae are aligned correctly in the spine, and rule out other conditions.
- Magnetic resonance imaging (MRI) scans: An MRI study produces detailed images of the spinal cord and its canal. This scan can reveal a compressed spinal cord and the reason for it, such as whether the issue is the presence of a bulging or a herniated disk.
- Myelogram: This is a specialized CT scan in which a contrast dye material is infused into the spinal canal so that the spinal cord and its nerve roots appear clearly, revealing any abnormalities.
- Electromyogram: This is an electrical test that checks the functioning of the nerves in the extremities.
Risk Factors for Myelopathy
Common risk factors for myelopathy include:
- Aging: One of the most common risk factors for the development of myelopathy is the natural aging process and degeneration. As a person gets older, the spinal cord tends to compress due to daily wear and tear changes that invariably increase the risk of a herniated disc or bone spurs.
- Excess body weight: People who are overweight or obese tend to have an increased risk of developing myelopathy, as excessive body weight places increased amounts of stress on the spine, causing it to degenerate at a faster rate.
- Active participation in certain sports activities: Contact sports that often involve collisions and repetitive motions can lead to accelerated spine degeneration and, eventually, spinal cord compression. Sudden traumatic injuries to the back during sports activities may also cause bulging discs that exert pressure on the spinal cord. Sports activities that increase the risk of spinal injuries and myelopathy include football, golf, gymnastics, rugby, and hockey.
- Genetic factors: A person's inherited genes may make them more susceptible to degenerative spine disease that can lead to the development of myelopathy. Sometimes, people with a congenitally narrow spinal canal may develop degenerative spinal stenosis, which can cause spinal cord impingement.
Causes of Myelopathy
Generally, myelopathy occurs as a result of age-related degenerative changes in the spinal discs. With increasing age, the discs become stiff as they lose water content and collapse. This leads to the formation of bone spurs around the disc, which narrow down the spinal canal, resulting in compression of the spinal cord. Movements such as lifting, bending, twisting, and pulling may lead to a herniated disc that in turn exerts pressure on your spinal cord.
Other conditions, such as rheumatoid arthritis and traumatic injury to the spinal cord, may also cause myelopathy. The traumatic spinal injuries that give rise to myelopathy occur as a result of automobile collisions, accidental occupational injuries, falls, assaults, and sports injuries.
Several alternative treatment methods have been effective in relieving the symptoms of compressed spinal cord and myelopathy. A doctor will advise the most appropriate method based on a patient's individual condition. These methods include:
- Acupuncture/Acupressure: Acupuncture is a treatment based on an ancient technique used in Chinese medicine. Acupuncture involves the insertion of fine needles into certain points of the body, which help relieve pain by promoting the release of natural endorphins in the blood. Acupressure involves the stimulation of specific areas in the body using fingers to exert pressure.
- Traditional massage therapy: Massage seems to be effective in reducing the pain that results from the narrowing of the spinal canal. Based on the severity of the problem, different kinds of massage techniques are used. Massage therapy is generally considered to be a safe method, but caution should be taken to avoid aggravating inflamed joints.
As myelopathy is a condition that results from the narrowing of the spinal canal (stenosis), some preventive measures should always be taken in order to avoid the stenosis itself. Although certain causes of spinal stenosis, such as traumatic injury, cannot always be prevented, you can take the following preventive measures:
- Maintain a correct posture: It is important to maintain correct posture, especially while working and driving, in order to prevent strain on the spinal structures.
- Maintain a healthy weight: If you are obese, try to shed excess weight in order to reduce the pressure that is exerted on your spine.
- Regular exercise: Performing regular exercises, including stretching and weight-bearing activities, can help you maintain flexibility and strength in your spine.
Are you experiencing symptoms of myelopathy? If you have any concerns related to spinal injury, the highly skilled spinal surgeons at Cedars-Sinai Marina del Rey Hospital are here to help.