Myelopathy is a chronic (ie, slow and prolonged) compression of the spinal cord, usually in the neck. Although it can appear in young people (due to a sustained compression over time), it often affects older adults. It affects men at a younger age than women.
In the cervical cord are the nerves that carry the signals from the brain to the muscles. However, they also send to information that they collect from the body to the brain.
When this area narrows, the cord is compressed and the nerve cells are disrupted, preventing proper functioning of the cord. The affected area is usually between vertebrae C4 and C7.
Cervical osteoarthritis is a frequent cause. As in any joint affected by osteoarthritis, the bone grows excessively and the canal of the vertebrae narrows. Another cause of narrowing of the medullary canal is herniated discs. If they are especially large and central, can produce a direct compression of the medulla. Although it is less common, hereditary factors are also influential in this disease.
The symptomatology includes neck pain, sensory and motor symptoms.
The motor signs and symptoms are usually the most prominent:
- A weakness of predominance in the upper limbs.
- Weakness and spasticity in the lower limbs.
- Alteration of the gait.
- Difficulty in walking.
- The weakness and lack of balance cause the steps to be slow, small and with the legs more separated than normal.
The sensory symptoms are more variable and tend to debut in distal parts of the upper limbs, since where it is most reflected is a feeling of clumsiness in the hands, strength loss. There may also be tingling sensations in the lower limbs.
There are medical treatments and rehabilitation to stop osteoarthritis of the vertebrae. The pharmacological treatment, similar to that of cervical radiculopathy, will be aimed at pain relief. The application of local physiotherapy also improves pain and discomfort caused by vertebral arthrosis.
The most effective treatment is surgery when the marrow is compressed, injured, and with obvious and bothersome symptoms.
There are several surgical options to treat this pathology: corpectomy, laminectomy, laminoplasty and anterior discectomy. In almost all techniques when decompression is performed, stabilizations (or fixings) are associated with metallic materials such as plates and screws.