Spinal Cord Diseases – Myelopathy

The beginning of the spinal cord is at the base of the brain, and it continues through the body canal of the cervical and thoracic portions of the spine, to end in the upper region of the lower spine as a bundle of individual nerve fibers. At each level, the spinal cord carries the neural impulses to the regions below that particular level. The spinal cord contains fibers that transmit impulses to arms, chest, legs, and in the upper cervical spine. The disorder in the spinal cord that disrupts or interrupts the normal transmission of the neural signals is called myelopathy in the clinical syndromes. For anatomical reasons, the involvement in arms and hands, legs, and bladder functions is by cervical myelopathy.

Spinal Cord DiseasesA clinical myelopathy can be caused by anything that interrupts the normal flow of neural impulses through the spinal cord. Trauma, viral processes, inflammatory or autoimmune disorders, tumor, or degenerative processes including spondylosis and intervertebral disc herniation are some of the causes. The enclosed bony tube through which the spinal cord runs is called the spinal canal. The space surrounding the spinal cord is generally filled with a few millimeters of fluid. This fluid helps in protecting it from trauma, and allows considerable flexibility. However some people are born with smaller than average spinal canal. This is called congenital cervical spinal stenosis. Due to degeneration changes with the spine, the cervical spinal canal may become narrower over the time. The encroachment on the spinal cord may occur due to bone spurs, disc bulges, and thickened ligaments. In some cases, the pressure on the spinal cord increases when the space normally surrounding the spinal cord is severely compromised.

The involvement of the levels of the spinal and the pattern of the involvement gives the symptoms of myelopathy. Numbness of the hands, clumsiness of the hands, arm weakness, and leg weakness, loss of balance, and urinary urgency may be the symptoms. Frequent neck pain is not a significant complaint however it may be present. The timing of the appearance of symptoms and their progression also vary from person to person. The rate of progression of symptoms may change over time. The period of relatively rapid changes interspersed with periods of stability, or minimal progression can happen differently in different individuals.

To remove the pressure from the spinal cord, myelopathy is the key treatment. To prevent the progression of symptoms, the surgery is performed. In this process, the clinical improvement may or may not occur. One needs to discuss their prognosis with their neurosurgeon prior to make a decision of having the surgery. To decompress the spinal cord, surgical procedure may include approaches from the front of the neck, from the back of the neck, or the combined procedures in which both an anterior and a posterior approach is used. The location of the stenosis and the overall alignment of the cervical spine decides the exact procedure performed in the surgery of myelopathy, however many factors are taken into consideration while making the decision.

News About Spinal Cord Diseases:
Hepatic Myelopathy
Degenerative Myelopathy
Cervical Spondylotic Myelopathy

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