Your spinal cord is the large bundle of nerves running all the way down your neck and upper back. One on the main functions of your spine is to protect this vital structure, but sometimes the bones become misaligned, spinal joints degenerate, protective disks slip, or inflammation occurs, all of which can put unusual pressure on the spinal cord. Occasionally, an infection or tumor can pinch the spinal cord. The symptoms that result from this are known as myelopathy.
As myelopathy occurs in different parts of your spine, symptoms can vary. The most common form is cervical myelopathy affecting your neck, which causes weakness or numbness in your hands, difficulty with balance, falls, changes in handwriting, and difficulty with fine manipulative tasks, such as buttoning buttons or tying shoes. Thoracic myelopathy occurs in the middle portion of the spine, causing pain and weakness in your legs.
Symptoms are usually subtle at first but can worsen over time. As well as increasing pain, you may begin to have a weakened grip and trouble walking. If left untreated, myelopathy can lead to incontinence and paralysis.
Myelopathy typically develops slowly, as the result of changes in the bones and surrounding tissue that happen as part of the aging process. Arthritis causes bone spurs to grow, and these can press up against the nerves and the spinal cord, preventing them from functioning properly. Some people have congenitally small spinal canals leading to myelopathy at a relatively young age.
Growths, such as cysts, tumors or infections, can also lead to impingement on the spinal cord. Dr. Oshtory can determine the specific cause of myelopathy in each case with imaging studies, such as MRI or CT scans.
Dr. Oshtory conducts a careful physical examination, testing your strength, sensation, balance and reflexes. He also performs tests that let him look at the structure of your spine. An X-ray picks up any mechanical issues, while an MRI scan shows problems within the spinal canal and can even show damage within the spinal cord itself.
All these tests enable Dr. Oshtory to pinpoint the exact site of the myelopathy and to find out what might have caused it — like a herniated disc or a cyst.
Depending on the severity of your myelopathy, its causes, and your personal medical history, Dr. Oshtory may recommend spinal decompression surgery to relieve the pressure. He offers minimally-invasive techniques that allow for swift recovery.
Sometimes decompressing and fusing the spine from the front is the best approach. Other times a laminoplasty can be performed from the back. This procedure raises up the bone covering the spinal cord like a trap door, avoiding the need for a fusion while maintaining range of motion.