Myelopathy

Myelopathy is a pinched nerve in the spinal cord that affects the entire spinal cord. It usually develops gradually as the space around the spinal cord (the spinal canal) narrows with age. The narrowing is called spinal stenosis.

Bone spurs and arthritis can narrow the spinal canal, and the spurs and other tissue can press on the spinal cord and nerves.

Symptoms

  • Pain
  • Weakness in arms or legs
  • Numbness or tingling in arms or legs
  • Loss of coordination or balance

Diagnostic tests

  • Electromyography: In this test, also called EMG, the doctor inserts tiny needles into muscles and asks you to gently squeeze the muscle. This sends signals to the electrodes that are recorded on a graph.
  • Nerve conduction studies: In these tests, also called NCS, the doctor tapes small electrodes over muscles and uses a mild electrical current to test nerves.

Nonsurgical treatments

Mild or moderate symptoms can often be treated without surgery, an approach the OHSU Spine Center favors whenever possible.

  • Medication: Nonsteroidal anti-inflammatory medications such as ibuprofen can help.
  • Physical therapy: Training to avoid positions or movements that put stress on the spinal cord can help.
  • Wearing a soft cervical collar
  • Use of a cane or walker
  • Occupational therapy to help with activities such as showering, opening jars and turning keys.

Surgical treatments

Surgery may be recommended if your myelopathy is severe and other treatments don’t help. It also may be needed if you have muscle weakness, a sign that pressure is damaging the spinal cord and nerves.

  • Laminotomy/laminectomy: This surgical procedure removes part of a spinal bone called the lamina to relieve pressure on nerves or the spinal cord.
  • Spinal fusion surgery: This surgery permanently joins two or more bones (vertebrae) in the spine for more stability.