What is myelopathy and how does it differ from other spinal conditions. What are the common causes of myelopathy. How is myelopathy diagnosed and what are its symptoms. What are the different types of myelopathy and their characteristics.

Understanding Myelopathy: A Comprehensive Overview

Myelopathy is a serious condition that affects the spinal cord, potentially causing significant neurological impairment. This article delves into the intricacies of myelopathy, exploring its causes, symptoms, and diagnostic approaches.

Defining Myelopathy

Myelopathy refers to an injury to the spinal cord resulting from severe compression. This compression can stem from various factors, including trauma, congenital stenosis, degenerative disease, or disc herniation. The spinal cord, a bundle of nerves housed within the spine, runs nearly the entire length of the back. When any part of this vital structure becomes compressed or constricted, the resulting symptoms are collectively known as myelopathy.

Distinguishing Myelopathy from Related Conditions

It’s crucial to differentiate myelopathy from similar-sounding conditions:

• Myopathy: A muscular disorder, not to be confused with myelopathy, which involves nerve damage within the spinal cord.
• Radiculopathy: While myelopathy may coexist with radiculopathy, the latter specifically refers to the pinching of nerve roots as they exit the spinal cord or cross the intervertebral disc, rather than compression of the cord itself.

Types of Myelopathy: Location Matters

Myelopathy can occur in different regions of the spine, each with its own designation:

Cervical Myelopathy

Occurring in the neck region, cervical myelopathy is the most common form. Interestingly, while neck pain can be a symptom, not all patients experience it.

Thoracic Myelopathy

This type affects the middle region of the spine. Compression of the spinal cord in this area typically results from bulging or herniated discs, bone spurs, or spinal trauma.

Lumbar Myelopathy

A rare condition, lumbar myelopathy affects the lower back. It’s uncommon because the spinal cord typically ends in the upper section of the lumbar spine for most people. However, individuals with a low-lying or tethered spinal cord may be susceptible to lumbar myelopathy.

Unraveling the Causes of Myelopathy

Myelopathy can develop due to various factors, both gradual and acute:

Age-Related Degeneration

As we age, inflammation, arthritic conditions, bone spurs, and the flattening of spinal discs can exert pressure on the spinal cord and nerve roots. This gradual degeneration of the spine, known as spondylosis, is a common cause of myelopathy.

Spinal Stenosis

A narrowing of the bony passageways in the spine through which the spinal cord and nerve roots travel, spinal stenosis is a frequent culprit in myelopathy cases.

Disc Herniation

Central disc herniations can lead to compression of the spinal cord, potentially resulting in myelopathy.

Autoimmune Disorders

Conditions such as rheumatoid arthritis in the spine can trigger degenerative changes in the vertebrae, leading to spinal cord compression and myelopathy.

Tumors and Other Growths

Hernias, cysts, hematomas, and spinal tumors, including bone cancer, may exert pressure on the spinal cord, causing myelopathy.

Acute Causes

Myelopathy can also develop rapidly due to spinal injury, infection, inflammatory disease, radiation therapy, or neurological disorders.

Recognizing the Symptoms of Myelopathy

Compression or injury to the spinal cord can manifest in various ways, often affecting sensation, function, and comfort. Common symptoms include:

• Pain in the neck, arms, legs, or lower back
• Tingling, numbness, or weakness
• Difficulty with fine motor skills (e.g., writing, buttoning shirts)
• Increased reflexes in extremities or development of abnormal reflexes
• Difficulty walking
• Loss of urinary or bowel control
• Balance and coordination issues

The specific symptoms can vary depending on the location of the myelopathy. For instance, cervical myelopathy often presents with symptoms in the neck and arms.

Diagnosing Myelopathy: A Multi-Faceted Approach

Given that myelopathy symptoms are not unique to this condition, healthcare providers employ various diagnostic tools to confirm the presence of myelopathy:

Imaging Studies

• X-rays: Used to rule out other potential issues
• MRI scans: Provide detailed views of the spine and spinal canal, revealing areas of stenosis
• Myelography: Utilizes contrast material and real-time X-ray (fluoroscopy) to highlight spinal cord abnormalities, sometimes used as an alternative to MRI for patients unable to undergo magnetic resonance imaging

Electrical Tests

Tests such as electromyograms (EMG) or somatosensory evoked potentials (SSEP) assess nerve function, measuring how nerve stimulation in the extremities connects through the spinal cord to the brain.

Diagnostic Terminology

When communicating a myelopathy diagnosis, healthcare providers may use specific terminology. Often, “myelopathy” is added to the end of an underlying condition to indicate spinal cord involvement. For example, a diagnosis might be stated as “cervical stenosis with myelopathy” or “thoracic disc disorder with myelopathy.” Conversely, if the spinal cord is not affected, the diagnosis may include “without myelopathy.”

Treatment Options for Myelopathy: From Conservative to Surgical

The management of myelopathy depends on various factors, including the severity of symptoms, the underlying cause, and the patient’s overall health. Treatment approaches can be broadly categorized into conservative and surgical options:

Conservative Management

For mild cases or when surgery is not immediately necessary, conservative treatments may be recommended:

• Physical therapy: To improve strength, flexibility, and posture
• Pain management: Including medications and injections to alleviate discomfort
• Lifestyle modifications: Such as ergonomic adjustments and activity modifications
• Bracing: In some cases, a cervical collar or other supportive devices may be prescribed

Surgical Interventions

When conservative measures fail to provide relief or in cases of severe myelopathy, surgery may be necessary. Surgical options can include:

• Decompression surgery: To relieve pressure on the spinal cord
• Spinal fusion: To stabilize the affected area of the spine
• Disc replacement: In some cases, artificial disc replacement may be an option

The specific surgical approach will depend on the location and nature of the spinal cord compression.

Living with Myelopathy: Long-Term Outlook and Management

The prognosis for individuals with myelopathy can vary significantly based on several factors:

Factors Influencing Prognosis

• Severity of spinal cord compression
• Duration of symptoms before treatment
• Age and overall health of the patient
• Effectiveness of treatment interventions

Ongoing Management

For many patients, managing myelopathy is an ongoing process that may involve:

• Regular follow-up appointments with healthcare providers
• Continued physical therapy or rehabilitation
• Adaptations to daily activities to accommodate any lasting limitations
• Monitoring for potential progression of symptoms

Quality of Life Considerations

While myelopathy can significantly impact an individual’s life, many patients experience substantial improvement with appropriate treatment. However, some may need to make long-term adjustments to their lifestyle or work situation to accommodate any residual effects of the condition.

Preventing Myelopathy: Proactive Measures for Spinal Health

While not all cases of myelopathy can be prevented, there are steps individuals can take to promote overall spinal health and potentially reduce their risk:

Maintaining Good Posture

Proper posture, especially during prolonged periods of sitting or standing, can help reduce stress on the spine.

Regular Exercise

Engaging in regular physical activity, particularly exercises that strengthen the core and promote flexibility, can support spinal health.

Ergonomic Considerations

Ensuring that workspaces and daily activities are ergonomically optimized can help minimize strain on the spine.

Healthy Lifestyle Choices

Maintaining a healthy weight, not smoking, and managing chronic conditions like diabetes can all contribute to better spinal health.

Regular Check-ups

Routine medical check-ups can help identify potential spinal issues early, allowing for prompt intervention if necessary.

Emerging Research and Future Directions in Myelopathy Treatment

The field of myelopathy research is dynamic, with ongoing studies exploring new treatment modalities and diagnostic techniques:

Stem Cell Therapy

Researchers are investigating the potential of stem cell therapies to regenerate damaged spinal cord tissue in myelopathy patients.

Advanced Imaging Techniques

New imaging modalities are being developed to provide more detailed and accurate visualizations of spinal cord compression and associated neural changes.

Minimally Invasive Surgical Techniques

Ongoing refinements in minimally invasive surgical approaches aim to reduce recovery time and improve outcomes for myelopathy patients requiring surgical intervention.

Neuroprotective Strategies

Studies are exploring various neuroprotective agents that could potentially limit damage to the spinal cord in acute myelopathy cases.

Rehabilitation Technologies

Advancements in rehabilitation technologies, including robotic assistance and virtual reality-based therapies, show promise in improving functional outcomes for myelopathy patients.

As research in these areas progresses, it is anticipated that new treatment options and improved management strategies for myelopathy will emerge, potentially offering better outcomes and quality of life for affected individuals.

Myelopathy | Johns Hopkins Medicine

What is myelopathy?

Myelopathy is an injury to the spinal cord due to severe compression that may result from trauma, congenital stenosis, degenerative disease or disc herniation. The spinal cord is a group of nerves housed inside the spine that runs almost its entire length. When any portion of the spinal cord becomes compressed or constricted, the resulting symptoms are known as myelopathy.

Myelopathy Versus Myopathy

Myopathy is a muscular disorder and should not be confused with myelopathy, which has to do with nerve damage inside the spinal cord.

Myelopathy Versus Radiculopathy

Myelopathy may sometimes be accompanied by radiculopathy. Radiculopathy is the term used to describe pinching of the nerve roots as they exit the spinal cord or cross the intervertebral disc, rather than the compression of the cord itself (myelopathy).

Types of Myelopathy

Myelopathy can occur in any area of the spine and has a different name depending on where in the spine it appears.

Cervical Myelopathy

Cervical myelopathy occurs in the neck and is the most common form of myelopathy. Neck pain is one of the symptoms of cervical myelopathy, but not all patients experience it.

Thoracic Myelopathy

Thoracic myelopathy occurs in the middle region of the spine. The spinal cord in this area typically gets compressed due to bulging or herniated discs, bone spurs, or spinal trauma.

Lumbar Myelopathy

Lumbar myelopathy is a rare condition because in most people, the spinal cord ends in the top section of the lumbar spine. However, if the spinal cord is low-lying or tethered, it can be affected by lumbar myelopathy.

Causes of Myelopathy

As you age, inflammation, arthritic illness, bone spurs and the flattening of the spinal discs between the vertebrae can put pressure on the spinal cord and the nerve roots. Myelopathy typically develops slowly as result of the gradual degeneration of the spine (spondylosis), but it can also take an acute form or stem from a spine deformity present at birth.

• Common causes of myelopathy are degenerative spinal conditions, such as spinal stenosis, a narrowing of the bony passageways of the spine through which the spinal cord and nerve roots travel.
• Central disc herniations can also result in compression on the spinal cord, leading to the development of myelopathy.
• Autoimmune disorders, such as rheumatoid arthritis in the spine, can also lead to degenerative changes in the vertebrae that result in spinal cord compression and myelopathy.
• Hernias, cysts, hematomas and spinal tumors, including bone cancer, may also press on the spinal cord and lead to myelopathy.
• Acute myelopathy can develop quickly as a result of a spinal injury, spinal infection, inflammatory disease, radiation therapy or neurological disorders.

Below is an example of how a herniated disc may press on the spinal cord, leading to myelopathy.

Symptoms of Myelopathy

When the spinal cord is compressed or injured, it may cause a loss of sensation, loss of function, and pain or discomfort in the area at or below the compression point. Myelopathy symptoms may include:

• Neck, arm, leg or lower back pain
• Tingling, numbness or weakness
• Difficulty with fine motor skills, such as writing or buttoning a shirt
• Increased reflexes in extremities or the development of abnormal reflexes
• Difficulty walking
• Loss of urinary or bowel control
• Issues with balance and coordination

The exact symptoms will depend on where in the spine myelopathy is present. For example, cervical myelopathy is likely to have symptoms in the neck and arms.

Myelopathy Diagnosis

Symptoms of myelopathy are not unique to this condition. Your doctor may recommend the following tests to narrow down the myelopathy diagnosis:

• An X-ray to rule out other problems
• An MRI scan for a detailed look of the spine and spinal canal, which can show areas of stenosis
• Myelography uses a contrast material and a real-time form of an X-ray called fluoroscopy to reveal abnormalities of the spinal cord. It is sometimes used instead of MRI for patients who can’t be inside an MRI machine.
• Electrical tests, such as an electromyogram or somatosensory evoked potentials, show how well your nerves are functioning to provide sensation and movement ability to your arms and legs. These tests measure how nerve stimulation in a hand, arm, leg or foot is connecting through the spinal cord to the brain.

The diagnosis itself may be communicated to you by your doctor in several different ways. Sometimes, myelopathy is added at the end of another underlying condition to indicate the involvement of the spinal cord. For example, your doctor may tell you that you have cervical stenosis with myelopathy or thoracic disc disorder with myelopathy. Similarly, if the spinal cord is not involved, your diagnosis may say without myelopathy, as in displaced lumbar intervertebral disc without myelopathy.

If myelopathy is a complication of another disease, your doctor may refer to it in the terms of this disease. For example, diabetic myelopathy means that the spinal cord has been damaged due to diabetes. Carcinomatous myelopathy means that the spinal cord has suffered damage due to a carcinoma.

Myelopathy Treatment

Myelopathy treatment depends on the causes of myelopathy. However, in some cases, the cause may be irreversible, so the treatment may only go as far as helping you relieve the symptoms or slowing down further progression of this disorder.

Nonsurgical Myelopathy Treatment

Nonsurgical treatment for myelopathy may include bracing, physical therapy and medication. These treatments can be used for mild myelopathy and are aimed at reducing pain and helping you return to your daily activities.

Nonsurgical treatment does not remove the compression. Your symptoms will progress — usually gradually, but sometimes acutely, in some instances. If you notice progression of your symptoms, talk to your doctor as soon as possible. Some of the progression can be irreversible even with treatment, which is why it’s important to stop any progression when identified in the mild stages.

Surgical Myelopathy Treatment

Spinal decompression surgery is a common treatment for myelopathy to relieve pressure on the spinal cord. A surgery can also be used to remove bone spurs or herniated discs if they are found to be the cause of myelopathy.

For advanced myelopathy caused by stenosis, your doctor may recommend a surgical procedure to increase the channel space of your spinal cord (laminoplasty). This is a motion-sparing procedure, which means your spinal cord retains flexibility at the site of the compression. For various reasons, some patients may not be candidates for a laminopasty. An alternative is decompression and spinal fusion that can be done anteriorly (from the front) or posteriorly (from the back). During spinal fusion, vertebrae are fused to eliminate motion in the affected segment of the spine.

Minimally invasive spine surgery may offer relief with a lower risk for complications and a potentially faster recovery than conventional open surgery procedures.

While you’re awaiting surgery, a combination of exercise, lifestyle changes, hot and cold treatments, injections, or oral medication can help you control any pain symptoms. It’s very important to take any medications exactly as your doctor prescribes them, since many pain medicines and muscle relaxers can cause side effects, especially when used for a long time.

Lumbar Myelopathy | Spine Care

Key Points about Lumbar Myelopathy 

• Lumbar myelopathy occurs when the spinal cord is compressed.
• Lumbar myelopathy is diagnosed using imaging tests and electrical studies.
• The most common treatment for lumbar myelopathy is decompression surgery.

Common related conditions

Compression Fractures
Disc (Disk) Herniation
Sciatica

Myelopathy is an injury that occurs due to severe compression to the spinal cord. This compression may result from trauma, congenital stenosis, degenerative disease or a herniated disc. Lumbar myelopathy occurs when the middle area of the spine is compressed.

Lumbar myelopathy causes 

The various causes of lumbar myelopathy include:

• Bone spur
• Cyst or hematoma in the spine
• Degenerative spine conditions, such as spinal stenosis (narrowing of the bones of the spine that compresses the spinal nerves)
• Herniated disc
• Rheumatoid arthritis in the spine
• Spinal injury or infection
• Spinal tumor, including bone cancer

Lumbar myelopathy risk factors

If you have any of the following conditions, your risk developing lumbar myelopathy may increase:

• Bone cancer or a spinal tumor
• Herniated disc
• Rheumatoid arthritis in your spine
• Spinal stenosis
• Spine infection
• Traumatic spinal injury

Lumbar myelopathy symptoms

Signs and symptoms of lumbar myelopathy include:

• Difficulty with coordination
• Difficulty with fine motor skills, such as holding a pen to write or using a zipper
• Pain in the neck, arm, leg or lower back
• Tingling, numbness or weakness
• Trouble keeping your balance
• Trouble walking
• Urinary or stool incontinence

Lumbar myelopathy diagnosis

Your specialist may use the following tests to diagnose your lumbar myelopathy:

X-ray. Your specialist may order an X-ray to rule out any other conditions that can cause similar symptoms.

Magnetic resonance imaging (MRI). Your doctor may order an MRI to obtain a detailed image of your spine and spinal cord.

Electrical tests. Your specialist may order an electrical test – such as an electromyogram or somatosensory evoked potentials – to check how well your nerves are working.

Lumbar myelopathy treatment

Your doctor may recommend one or more of the following treatments for your lumbar myelopathy:

Medication. Your specialist may recommend medications to help relieve pain associated with your lumbar myelopathy.

Physical therapy. You may work with a physical therapist to help you how to more easily complete daily tasks. As part of this, you may need to wear a brace.

Spinal decompression surgery. In this procedure, your specialist removes the cause of your lumbar myelopathy, such as a bone spur or herniated disc.

Laminoplasty. In this treatment for more advanced types of myelopathy, your specialist widens the space through which your spinal cord passes. This helps to relieve pain and other symptoms.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing a spine specialist for more specialized treatment.

Find a spine specialist near you

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symptoms, diagnosis, treatment and prognosis

Content

• 1 Myelopathy of the lumbar spine: symptoms, diagnosis, treatment and prognosis
  • 1.1 Myelopathy of the lumbar spine
  • 1.2 Myelopathy of the lumbar spine: main symptoms 900 08
  • 1.3 Causes of myelopathy of the lumbar spine
  • 1. 4 Diagnosis of myelopathy of the lumbar spine
  • 1.5 Diagnosis and treatment of myelopathy of the lumbar spine: which doctor will help
  • 1.6 Treatment of myelopathy of the lumbar spine
  • 1.7 Opportunities for surgical intervention in myelopathy of the lumbar spine
  • 1.8 Treatment of myelopathy of the lumbar spine: how is efficiency achieved?
  • 1.9 How to Maintain a Healthy Lumbar Spine
    • 1.9.1 Maintain Correct Posture
    • 1.9.2 Distribute the Load Evenly
    • 1.9.3 Wear the Right Shoes
    • 1.9.4 Choose the right mattress and pillow
    • 1.9.5 Monitor your weight
  • 1.10 Prognosis for lumbar myelopathy
  • 1.11 Additional advice for people with lumbar myelopathy of the spine
  • 1.12 Question-answer:
    • • 1.12.0.1 What symptoms are typical for myelopathy of the lumbar spine?
      • 1.12.0.2 How is myelopathy of the lumbar spine diagnosed?
      • 1.12.0.3 What treatment is recommended for myelopathy of the lumbar spine?
      • 1. 12.0.4 Can myelopathy of the lumbar spine lead to paralysis?
      • 1.12.0.5 What is the prognosis for myelopathy of the lumbar spine?
      • 1.12.0.6 Can exercise help treat myelopathy of the lumbar spine?
  • 1.13 Related videos:

Find out about the symptoms, diagnosis, treatment and prognosis of lumbar spine myelopathy on our website. All the information you need in one article.

Myelopathy of the lumbar spine is a disease characterized by dysfunction of the spinal cord. It can manifest itself in the form of lower back pain, numbness and weakness of the lower extremities, urination and defecation disorders are possible. Myelopathy can be caused by compression of the spinal cord as a result of bends and deformities of the spine, diseases of the bones and joints, tumors and disc herniation.

Diagnosis of myelopathy requires a comprehensive examination, including MRI and X-ray, laboratory tests and neurological examination. Specialists should identify the site of signal obstruction, determine its severity and determine the cause.

Treatment of spinal myelopathy can include both conservative methods (exercise, drug therapy, physical therapy) and surgery. However, the decision on the method of treatment should be made individually, based on the general condition of the patient and the degree of development of the disease.

The prognosis of spinal myelopathy also depends on many factors, including age, degree of spinal torsion, diagnosis, and treatment. Early detection and prevention of diseases of the musculoskeletal system can reduce the likelihood of developing myelopathy.

Myelopathy of the lumbar spine

Myelopathy of the lumbar spine is a disease that is associated with a malfunction of the spinal cord in the region of the lumbar spine. It manifests itself in the form of a feeling of numbness and weakness in the legs, lower back pain, changes in reflexes, impaired coordination of movements and other symptoms.

Myelopathy of the lumbar spine can be caused by a variety of causes such as herniated discs, spondylosis, tumors, and other conditions that compress the spinal cord.

To diagnose myelopathy of the lumbar spine, tests are performed to identify the presence of symptoms and determine the cause of the disease. Depending on this, treatment methods are prescribed, which may include conservative methods, physiotherapy, surgical interventions and other methods.

Myelopathy of the lumbar spine: main symptoms

Low back pain: constant, dull or sharp, may be aggravated by movement and sitting. Pain in the legs, hips, or buttocks may also occur.

Decreased sensation: The legs may first become numb, then the legs may feel cold or hot and tingling.

Decreased motor function: patients become more clumsy and unable to perform many movements. When walking, an incorrect distribution of the load is possible and they stagger when moving.

Loss of balance: due to decreased motor function, patients may lose balance and fall. This is especially evident when climbing stairs and when moving quickly.

Blood pressure spike: Patients may experience palpitations, dizziness, and lightness in the head when changing body position.

Reduced urinary function: patients may experience difficulty in urination, frequent desires or, conversely, urinary retention.

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Causes of myelopathy of the lumbar spine

Myelopathy of the lumbar spine develops due to compression of the spinal cord and nerve roots in the lumbar region. The main reasons for this compression are:

• Osteochondrosis of the spine. Changes in the structure of the intervertebral discs lead to their displacement towards the spinal cord.
• Spondylosis. This is a disease in which osteophytes occur at the top of the vertebrae, which also leads to compression of the spinal cord.
• Herniated disc. If the hernia is located in the lumbar region and compresses the spinal cord or roots, this can lead to the development of myelopathy.
• Spinal injuries. Incomplete or improperly treated injuries can lead to the development of myelopathy.
• Inflammatory processes. Inflammation of the tissues of the spine can cause swelling and compression of the spinal cord or roots.

It is important to understand that lumbar spine myelopathy is a serious disease that can lead to a deterioration in the patient’s quality of life. Therefore, it is necessary to consult a doctor in a timely manner and undergo regular preventive examinations for the timely detection and treatment of this disease.

Diagnosis of myelopathy of the lumbar spine

Myelopathy of the lumbar spine is a serious disease that poses a threat to the patient’s quality of life. Diagnosis of this disease is carried out by specialists of various medical specialties based on a comprehensive examination of the patient.

At the beginning of the diagnosis, the doctor examines the patient, asks about his symptoms and medical history, and performs a neurological and orthopedic analysis. Then, to confirm the diagnosis, additional research methods are carried out, such as radiology, computed tomography (CT) and magnetic resonance imaging (MRI).

X-ray can determine the presence and degree of spinal deformity, as well as detect prolapsed intervertebral discs. CT and MRI provide a more detailed picture, allowing you to see not only the structure of the spine, but also to determine the spots of cerebral pressure on the nerve fibers.

Electromyography and CBC can also be used to diagnose lumbar spinal myelopathy to rule out other possible conditions that may produce similar symptoms. Based on the results of a comprehensive examination, doctors prescribe the treatment that will be the best way to deal with myelopathy of the lumbar spine.

Diagnosis and treatment of myelopathy of the lumbar spine: which doctor will help

Myelopathy of the lumbar spine is a serious disease that requires immediate medical attention. For accurate diagnosis and proper treatment of the patient, you should contact a neurosurgeon or neurologist.

Diagnosis begins with a doctor’s examination, which will reveal the characteristic symptoms of the disease. Computed tomography, magnetic resonance imaging, as well as x-rays and other research methods may be required to confirm the diagnosis. Depending on the severity of the disease and its causes, appropriate therapeutic measures are prescribed.

Myelopathy of the lumbar spine can be treated with medication, physiotherapy, massage, spinal manipulation, and other methods.

It is important to remember that myelopathy of the lumbar spine involves different body systems, and treatment must be comprehensive and individual for each patient. Only a qualified doctor with extensive experience in this disease can properly diagnose and treat lumbar myelopathy.

Treatment of myelopathy of the lumbar spine

Myelopathy of the lumbar spine is a serious disease that requires comprehensive and timely treatment. The main goal of treating myelopathy is to prevent further progression of the disease and improve the patient’s quality of life.

The main treatments for myelopathy of the lumbar spine include:

1. Drug therapy – the use of anti-inflammatory and pain medications, as well as muscle relaxants to relieve muscle spasm.
2. Physiotherapeutic procedures – ultrasound treatment, electrical stimulation, kinesiotherapy, magnetotherapy.
3. Massage and therapeutic exercises aimed at strengthening and stretching muscles, improving blood supply and microcirculation in the spine.
4. Mode of physical activity – prevention of prolonged parking and sitting in one position, regular walks and light physical activity in accordance with the recommendations of the attending physician.
5. Surgical treatment – is used only in severe cases, when conservative treatment does not give the desired result, and consists in the removal of damaged areas of the spine.

Signs of improvement are shown within a few weeks after the start of treatment. The trick to treating myelopathy of the lumbar spine lies in the timely diagnosis of the disease and the initiation of treatment in the early stages. This allows you to reduce the treatment time and increase the percentage of positive results.

Opportunities for surgical intervention in case of myelopathy of the lumbar spine

Myelopathy of the lumbar spine is a rather serious disease that manifests itself as a dysfunction of the brain and spinal cord. One of the most significant methods of treatment and achieving the maximum effect is surgery.

Surgical intervention can be carried out in case of detection of depressions, hernias, tumors and other pathologies in the lumbar spine that cause myelopathy. Also, depending on the form of the disease, a number of operations for compressive myelopathy are provided.

The choice between surgical and conservative treatment is made depending on the severity and nature of the development of myelopathy. However, in cases of moderate to severe myelopathy, surgery is the most effective treatment.

Some of the main types of operations for myelopathy of the upper or middle spine: microdecompression, conservative treatment, dyskephtomy, correction of the structure of the spine, anterolisthesis, multilevel dyskeftomy.

Every operation uses a minimally invasive technique to ensure minimal trauma to the patient. In most cases, patients recover quickly after surgery and can return to their normal lives.

Treatment of myelopathy of the lumbar spine: how is efficiency achieved?

Myelopathy of the lumbar spine can lead to a significant deterioration in the patient’s quality of life. This disease is manifested by various neurological symptoms, which can lead to restrictions in movement and performance.

Currently, there is no single approach to the treatment of myelopathy of the lumbar spine. Treatment should be individualized and depends on many factors, such as the cause of the disease, the degree of damage to the nervous structures, the presence of concomitant diseases.

An integrated approach is used to achieve the effectiveness of the treatment of myelopathy of the lumbar spine. This may include drug therapy, physical rehabilitation, manual therapy, acupuncture, surgery, and other methods.

For each patient, an individual set of therapeutic measures is selected, which is aimed at reducing pain, improving functionality, and preventing further development of the disease.

• Medication: may include analgesics, anti-inflammatory and muscle relaxants;
• Physical rehabilitation: physiotherapy, stretching exercises, exercises to strengthen the back muscles;
• Manual therapy and acupuncture: aimed at relieving muscle tension and improving blood circulation;
• Surgery: may be recommended in severe cases where conservative treatment fails;

It is important to remember that the effectiveness of the treatment of myelopathy of the lumbar spine depends on the timely visit to the doctor and the correct choice of a set of therapeutic measures. Therefore, at the first signs of neurological symptoms, it is necessary to consult a specialist and undergo a comprehensive examination.

Keeping Your Lumbar Spine Healthy

Maintain Good Posture

Posture plays a big role in spinal health. Try to sit and stand straight, do not bend or bend. With the “humpback” position, the risk of developing myelopathy increases.

Distribute the load evenly

When exercising, especially lifting weights, do not overload the lumbar spine. It is better to distribute the load on all muscle groups and work under the supervision of a trainer.

Wear the right shoes

Wearing the wrong shoes can damage your spine. Choose shoes with stable soles and good cushioning to reduce impact on your lower back.

Choose the right mattress and pillow

Lying on a comfortable mattress and pillow promotes proper spinal alignment during sleep and helps reduce the risk of myelopathy.

Watch your weight

Being overweight puts extra strain on your spine, especially the lumbar region. Maintain a healthy weight through a balanced diet and moderate exercise.

Prognosis for myelopathy of the lumbar spine

The prognosis for myelopathy of the lumbar spine can be relatively favorable with timely and effective treatment. However, it all depends on the degree of damage to the myelon, the age of the patient and the presence of other diseases.

If myelopathy appears at an early age, then the prognosis may be somewhat better than at an older age. With severe violations of the final activity, without timely and effective treatment, the prognosis may be unfavorable.

One factor that influences prognosis is the cause of the myelopathy. If the cause is degenerative changes in the spine, then most patients have a favorable prognosis. If the cause is unknown or associated with infectious diseases, then the prognosis may be less optimistic.

Some patients may have continued sensory and motor disturbances even after treatment, especially if the pathological changes in the spine were significant enough.

However, with proper treatment, including drug therapy, physical therapy, and in some cases surgery, many patients can achieve full or partial recovery of function.

Additional recommendations for people with myelopathy of the lumbar spine

Exercise and physical activity. The basic rule in the treatment of lumbar myelopathy is moderate exercise, specialized exercise and regular physical activity. This helps to strengthen the muscles of the back and reduce the load on the spine. Walking, swimming, various exercises for stretching the back muscles, etc. are recommended.

Regular massage and stretching. In addition to exercise, massage can help reduce pain and strengthen back muscles. It is often recommended to do regular stretches targeting different areas of the back to relieve pressure on the spine.

Watch your diet. It is recommended to follow a diet aimed at strengthening muscles. It is also important to maintain a normal weight so as not to increase the load on the spine.

Avoid certain activities. Patients with lumbar myelopathy are advised to avoid certain activities that cause spinal mobility. Your doctor can give you more advice on which activities to avoid, depending on the severity of your illness.

Q&A:

What are the symptoms of myelopathy of the lumbar spine?

Characteristic symptoms of myelopathy of the lumbar spine include: back pain, numbness or burning sensation in the legs, loss of sensation and muscle strength in the legs, frequent falls, problems with coordination of movements.

How is myelopathy of the lumbar spine diagnosed?

Diagnosis of myelopathy of the lumbar spine includes neurological examination, X-ray and MRI examination of the spine, electromyography and computed tomography. It is also necessary to exclude other diseases that can lead to similar symptoms.

What treatment is recommended for myelopathy of the lumbar spine?

Treatment of myelopathy of the lumbar spine may include long-term physical therapy, but if this does not help, surgery may be required. In any case, with such a disease, you should immediately consult a doctor.

Can myelopathy of the lumbar spine lead to paralysis?

Yes, myelopathy of the lumbar spine can lead to impaired movement in the legs and even paralysis if left untreated. Therefore, it is important to consult a doctor in a timely manner and undergo regular medical examinations.

What is the prognosis for myelopathy of the lumbar spine?

The prognosis depends on the degree of development of the disease and the timeliness of the start of treatment. If treatment is started in the early stages of the disease, the prognosis may be favorable. However, with an advanced form of lumbar spine myelopathy, the prognosis may be less optimistic.

Can exercise help treat myelopathy of the lumbar spine?

Exercise can help strengthen muscles and improve coordination, but is not a good treatment on its own. In any case, the appointment of exercises should be carried out only by a doctor, under his supervision and depending on the degree of development of the disease.

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• Diagnostics
• Methods of treatment

Myelopathy is a collective term for any spinal cord injury of various origins. For example, myelopathy can be carcinomatous (associated with degeneration of the spinal cord associated with a cancerous process), compression (due to pressure on the spinal cord of a hematoma or tissues), radiation myelopathy (the spinal cord is destroyed from exposure to ionizing radiation – for example, during radiation therapy). When the cause of damage to the spinal cord is disease, then myelopathy is the name of this disease – for example, diabetic myelopathy.

Myelopathy can be caused by spinal cord injury (fracture or dislocation of the vertebrae), herniated disc (the intervertebral disc puts pressure on the spinal cord), osteoarthritis of the spine (spondylosis), or mass lesions such as tumors. Myelopathy can also be a clinical manifestation of infectious or inflammatory processes, as well as circulatory disorders in the vessels of the spinal cord (spinal stroke). The syndrome, which is the result of compression of the spinal cord on one side of the spinal cord at the level of the 10th thoracic vertebra and is accompanied by spastic paresis on the side of the spinal cord injury and loss of proprioception and pain and temperature sensitivity on the opposite side, is called Brown-Sekharovsky syndrome and is also considered a type of myelopathy. The causes of myelopathy can also be viruses, immune reactions, circulatory failure in the vessels of the spinal cord. In addition, myelopathy can develop as a result of demyelination (loss of the protective sheath of the nerve fiber) or as a reactive complication to such vaccinations as smallpox, measles, chickenpox.

Risk factors

Myelopathy due to injury or disease can occur at any age in both men and women. The degree of dysfunction depends on the level of damage to the spinal cord.
Most often, primary tumors of the spinal cord occur in people aged 30 to 50 years.
Spinal cord injuries are more common in men aged 15 to 35 years.
Cervical spondylogenic myelopathy is the most common spinal cord injury in individuals aged 55 years and older. An increased risk of developing cervical spondylogenic myelopathy is in people who are prone to repetitive injury – work that involves carrying heavy loads or playing sports such as gymnastics. Patients with vascular disease are at greater risk of blockage of the spinal arteries. Also, patients with multiple sclerosis may develop symptoms of myelopathy.
Incidence: Accurate information on the frequency of myelopathy is currently not available. However, information about some of the common causes of myelopathy exists. For example, in the US there are between 12 and 15,000 spinal cord injuries annually. It is believed that 5% – 10% of patients with cancer are likely to grow tumors in the epidural space, resulting in more than 25,000 cases of myelopathy per year, of which 60% will occur in the thoracic spine, and 30% in the lumbosacral spine.
The prevalence of cervical spondylogenic myelopathy is 50% in men and 33% in women over the age of 60 years.
Various tumors can lead to spinal cord compression, but primary spinal cord tumors are rare.

Symptoms and Diagnosis

Case History: The symptoms of myelopathy vary depending on the cause, the severity of the condition, and whether the condition causing the myelopathy is acute or chronic. In cases where spinal cord tumors are the cause, the compression or injury may be pain (which may also radiate to the arms or legs), sensory or movement disturbances, and/or contractures on one or the opposite side of the body. If the cause is osteoarthritis, there may be complaints of pain and soreness, decreased range of motion in the spine, weakness, and possible spinal deformities. Myelopathy may also present with bladder or bowel dysfunction, or loss of sensation or numbness in the genital area. Infections that cause myelopathy can cause fever, redness, swelling, and increased soreness. If a person has Brown-Séquard syndrome, then there may be spastic paralysis on the side of the spinal cord injury and loss of proprioception and pain, a feeling of heat on the other side of the body.

Examination

Routine neurologic examination may reveal disorders associated with root compression (eg, cervical radiculopathy) or spasticity in the legs. Muscle clonus may be a sign of an upper motor neuron disorder in the spinal cord. The study of reflex activity allows you to note changes in reflexes (which may be increased or decreased depending on the cause), as well as loss or change in sensitivity. A sensory test (from the lower extremities to the face) may be needed to determine the level of sensory impairment. In addition, it is useful to determine the activity of abdominal reflexes, which also allows you to clarify the level of damage. There may also be paralysis and/or decreased sensation in various parts of the body. It is also possible to reduce the volume of voluntary movements. Assessment of rectal function also has an important role in the diagnosis of myelopathy.

Diagnostic methods

Diagnostic methods depend on the clinical history and physical examination. X-rays, densitometry, computed tomography (CT), or magnetic resonance imaging (MRI) of the spinal cord can detect lesions within or near the spinal cord. Laboratory tests may be ordered to rule out other possible causes (such as vitamin B12 deficiency or heavy metal salt poisoning). An increased number of white blood cells (leukocytes) suggests an infection (meningitis or osteomyelitis of the spine). Elevated erythrocyte sedimentation rate (ESR) may be a sign of inflammation, infection, or tumor. A spinal tap may be done to obtain cerebrospinal fluid (CSF) for laboratory testing if meningitis or multiple sclerosis is suspected. Other diagnostic procedures may include bone or soft tissue biopsy, and cultures of blood and cerebrospinal fluid.

Treatment

Treatment depends on the cause of the myelopathy. For a fracture or dislocation of the vertebrae – painkillers (analgesics), traction, immobilization for several weeks, and rehabilitation therapy (physiotherapy, exercise therapy, massage). Surgical treatment to correct a spinal deformity may involve removing part of a broken vertebra and/or fixing broken vertebrae. Analgesics, NSAIDs, (steroids), and possibly physical therapy can be used to treat problems associated with arthritis. Medicines to treat multiple sclerosis may be helpful, including new drugs or steroids. Infections require drugs to clear the infection (antibiotics), to reduce fever (antipyretics), and possibly anti-inflammatory drugs (steroids) to minimize inflammation. Myelopathy due to spinal cord compression may require surgery to remove a tumor or a herniated disc (laminectomy).

Prognosis

The prognosis depends on the cause of the myelopathy and the presence of permanent damage to the nerve structures. Traction and immobilization can lead to a complete recovery if there was no spinal cord injury. Complete cure is possible with infections. In chronic diseases such as arthritis or osteoporosis, the effect of treatment may be temporary, or if the disease progresses, then permanent disability is possible, up to a wheelchair. Spinal cord injury or compression can lead to irreversible changes in the spinal cord, including loss of sensation in various parts of the body, as well as loss of voluntary movement in the limbs. Recovery after removal of the tumor depends on the residual damage and, if it is a cancerous tumor, then on metastasis. Recovery after removal of a herniated disc (discectomy) gives a good result, but only if the spinal cord has not undergone irreversible changes as a result of compression. Complications of myelopathy can include dependence on pain medications, persistent impairment of sensation and/or voluntary movement, spinal deformities, and bladder and bowel dysfunction.