Myelopathy

Myelopathy
Myelopathy is a term used to describe each
neurological deficits associated with the spinal cord.
Myelopathy is most often caused by bone marrow
compression back by osteophytes or disc extrusion of
the cervical vertebrae.
 Epidemiology
Spinal cord tumors are less prevalent than
intracranial tumors, with a ratio of 1: 4. While
the primary tumor in the spinal cord is very
rare, the incidence is only 1.3 per 100000
population. Especially found in young adults
or middle age and rarely in childhood or old
age.
Degrees of myelopathy can be set up:
a. Grade 0 : involves nerve, not accompanied by
disease in the spinal cord
b. Grade 1 : symptoms of disease in the spinal cord
are not difficult to walk.
c. Grade 2 : difficulty walking, but does not inhibit
daily activities.
d. Grade 3 : help in running.
e. Grade 4 : ability to develop with help.
f. Grade 5 : only on the seat or on the net.
 Etiology
In patients in their 50s the most common cause of
myelopathy is SERVICAL SPONDILOSIS.
In patients in their 40s and below, the most common
cause of myelopathy is MULTIPLE SKLEROSIS.

Other causes include disc herniation which is a

reduction in the diameter of the spinal canal and
spinal cord compression, spinal instability, congenital
stenosis
Pathophysiology
 Clinical Manifestations
People with myelopathy can experience one or more of the following symptoms:
1. A feeling of heaviness in the leg or slowness or stiffness in walking
2. Inability to walk fast
3. experience sensory disorders, but unless myelopathy worsens, it rarely reaches a
clear level
4. Intermittent shooting of pain to the arms and legs, especially when bending their
heads forward (known as the Lermitte phenomenon)

While other signs are:

1. Clumsy or weak hands, with thick feeling and weakness in the feet and hands.
2. Tonion of leg muscles increases
3. Stiff on the neck
4. Reflex tendon in the knee and ankle increases
5. Asymmetrical feeling in the legs and arms causes sensation of position on the arms
and legs to disappear so that it is difficult to walk.
6. Loss of control of the spinter, resulting in urinary incontinence.
7. Changes in intestinal peristaltic.
 Diagnosis
a. X-ray: An abnormal movement or an unstable hypopollotol
AP / Lateral vertebra / Oblique
b. CT-Scan: Muscle polyps with pieces can show osteopit in
the spinal colum.
c. MRI: Can show soft tissues around the back (nerves, disks)
all over.
d. EMG: evaluates the motoric pathways from the nerves.
e. SSEP: (Somato Sensory Evoked Potential) measures nerve
sensor capability. With an electrician in the action, it
stimulates arm or leg and then reads the signal in the brain.
f. Laboratory tests for pregnancy, routine, blood pressure,
complete urine.
 Management
Conservatory Therapy:
a. Physical Therapy
b. Control pain: rest, comfortable composition,
compresses, heat-treated ultrasound, traction
c. The nerve block is capable of injecting steroids into the
epidural
Surgery:
a. DisectomyFusion
b. Corpectom and strut graft
c. Laminectomy: Surgical procedure to reduce pressure
on backbone, due to spinal stenosis.
 Complications
• Loss of sensation
• Can't move freely
• Spinal deformities
• BAK often