Myelopathy has various options for treatment.
What is Myelopathy?
Myelopathy is a spinal cord pathology. It is called a spinal cord injury when trauma is the cause. If inflammation is the cause, it is referred to as myelitis. Vascular disease is called vascular myelopathy. Various parts of the spine can be affected: lumbar, thoracic, or cervical, and lateral, posterior, or anterior. As a result, different symptoms will arise, including bowel and bladder issues, sexual dysfunction, sensory problems, and reflex and motor symptoms.1 If there is radicular or local pain with the myelopathy, then infection, tumor or spondylosis are likely the cause. Disk herniation and spondylosis are the most common causes of myelopathy.2 To differentiate between cervical radiculopathy and cervical myelopathy in the cervical spine, the myelopathy “tends to creep up on patients”, whereas the radiculopathy presents as “pain traveling from the neck into a specific region of either arm”. Radiculopathy has symptoms of weakness or numbness. Early treatment can bring resolution within 12 weeks. In the case of cervical myelopathy, patients “feel their hands are clumsier”, they might have an unsteady gait, and they could experience numbness or weakness in the arms or legs. The prognosis is generally that most patients will experience deterioration with “stable periods in between the episodes”. Both the myelopathy and radiculopathy can be triggered by cervical stenosis, a “narrowing of the space for the spinal cord”.3 Patients with cervical stenosis and myelopathy may experience the legs feeling heavy, being unable to walk briskly, fine motor skills deterioration, cervical radiculopathy (arm pain), and shooting pains in the legs and arms when their head bends forward.4 Patients with cervical spondylosis might be misdiagnosed with arthritis.5 In fact, normal aging changes of the disks, degenerative wear-and-tear, and arthritis in the neck can lead to cervical spondylosis with myelopathy.6
Treatment for Myelopathy
Standard myelopathy treatment for patients with myelopathy and cervical spondylosis, for example, include NSAID medications and possibly antidepressants and anticonvulsants. Some patients may be given cervical collars to help prevent injury. The decreased range-of-motion, however, could be problematic as muscle atrophy may occur. After about 12 weeks of therapy, patients can assess if conservative measures worked. If they do not, surgery may be recommended.7 Chiropractic care may help with certain myelopathy cases. It is recommended that HVLA techniques (high-velocity, low-amplitude) be avoided and that patients receive any treatment while they are concurrently receiving neurologic care. There are some non-force chiropractic techniques available, including cervical flexion distraction and the Activator.8
Learn more about radiculopathy and chiropractic.