Myelopathy is the loss of nerve function caused by spinal disorders, which can be caused by injury or degenerative disease. Complete myelopathy results in no sensation below the origin of the injury, while incomplete myelopathy affects some functions below the injury. Cervical stenosis is a common cause, and surgery may be necessary to slow or stop its progression. Research is needed to address the problems caused by spinal injuries.
Myelopathy is the gradual loss of nerve function caused by spinal disorders. It can be caused directly by a spinal injury resulting in decreased sensation or paralysis, although a degenerative disease can also cause this condition, with varying degrees of loss of sensation and movement. Spinal cord injuries that cause this problem are classified as complete or incomplete, because the cord doesn’t have to be severed to reduce nerve function.
Complete myelopathy describes a spinal injury that causes no sensation below the origin of the spinal injury. For example, a person with a spinal injury slightly above the waist would not feel their legs, could not walk, would lose control of their bladder and bowel function, and would not have sexual function. This is termed complete because nothing below the lesion works. In incomplete myelopathy following spinal cord injury, considering the same type of lesion as above helps explain the distinction. A person in this case may have bladder, bowel, and sexual function, but still not be able to walk. In this type of injury, some functions below the spinal injury may not be affected or only partially affected.
The most severe complete cases are devastating. Injury to the upper areas of the spinal cord can result in loss of nerve function affecting virtually all systems, causing quadriplegia. This could make a person unable to walk, use their arms or control functions such as breathing without the help of a ventilator.
A common cause of myelopathy unrelated to surgical injury is cervical stenosis. As people age, there is a gradual compression and narrowing of the spine, which can result in the spine pinching surrounding nerves. Early signs may include heaviness in the legs, pain in the arms, and gradual loss of motor skills. A doctor evaluating a patient may notice increased muscle structure in the legs and poor coordination when a person walks. Other tests will look at your reflexes, which may be abnormal.
Treatment for cervical stenosis is surgery to decompress the spine. The goal of this surgery is to slow down or stop the progression of the stricture. Unfortunately, this surgery may not provide any relief, and spine surgery is usually complicated. In the elderly, the risks may far outweigh the benefits. If pain is present, the best course is sometimes pain management.
Many experts believe there is an urgent need for the medical community to address the problems caused by spinal injuries or progressive disease. It remains the hope of most people that research in this area will continue until the devastation caused by spinal damage can be undone.
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