Myelopathy is defined as abnormal function of the spinal cord. Myelopathy is a concerning condition because it can result in loss of the use of hands or the ability to walk if left untreated. Once spinal cord damage occurs, it is often not fully reversible. Myelopathy can arise at any level of the spinal cord but most commonly arises from a problem in the neck. The usual time course for symptoms of myelopathy is a gradual onset and slow progression over months and years. Myelopathy more commonly affects adults age 50 and older.
Myelopathy results in weakness of the hands and/or legs, problems with walking, balance, and coordination. Loss of normal bowel, bladder, or sexual function may develop. The condition is often painless, unless accompanied by radiculopathy, which is compression of a nerve root, which causes radiating pain.
Treatment for myelopathy is based upon the underlying cause. Physical therapy can be useful in mild cases. Compression of the spinal cord often needs to be treated with surgical decompression. Tumors and bleeding are often treated with surgical removal for diagnosis and treatment. Multiple sclerosis and inflammatory disorders are generally treated with immune suppression.