Myelopathy

Symptoms

Signs that the long nerve tracts inside the spinal cord are affected include:

• Tightness in the muscle tone of the legs
• Deep tendon reflexes in the knee and ankle are heightened
• When the ankle is forced to extend, the foot beats up and down rapidly
• When the sole of the foot is scratched, the reflex of the big toe goes up instead of down
• Flicking the middle finger may cause the thumb and index finger to flex
• Coordination problems, including difficulty walking and placing one foot in front of the other foot

Causes and Risk Factors

A nerve can become pinched for a variety of reasons, including:

• 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
• Bone spurs or roughness inside the spinal canal that irritate the nerve
• Injuries

Conditions such as cervical or spinal stenosis may cause myelopathy.

Diagnosis

A doctor will take a patient's medical history and do a physical examination. As with any condition that affects the spine, it is important to rule out other conditions that may have similar symptoms.

A doctor may order the following tests to help diagnose the condition:

• X-rays to rule out abnormal motion and instability
• Magnetic resonance imaging (MRI) scan
• Computed tomography (CT) scan

Treatment

Treatment will vary depending on the cause of the condition, its location and how severe the symptoms are.

One approach to treatment is surgical decompression of the spinal canal. This creates more space for the spinal cord and nerves.

Surgical decompression can be done by approaching the spine either from the front or the back. The approach depends on where the majority of compression is located. There may be several levels of the spine where pressure is occurring. Because of that, this type or surgery tends to be more involved than that for disc herniation or foraminal stenosis.

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