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What happens to patients with myelopathy?
In the medical literature patients with myelopathy
have been followed once the disease begins. No pa-
tient ever returned to normal state. They have found
75% of patients had episodic worsening of symp-
toms. 20% of patients had a slow steady progression
of worsening symptoms. And 5% had a rapid onset
of disability followed by a lengthy disability.
Some patients notice a stepwise degeneration with
periods of stability between exacerbations. This
means they have symptoms and may feel bad for a
period then stabilize for a certain number of months
or years until the next episode. 55% of these patients
continue to have moderate long term morbidity.
What are my surgical treatment options?
The traditional type of surgery for cervical spinal ste-
nosis is a decompressive
Laminectomy.
This relieves
pressure on the spinal cord and the spinal nerve
roots. A Laminectomy removes the entire Lamina or
bony shelf to create space for spinal cord so that it
can have an environment where it can heal.
Laminectomy Section of Bone
Removed
The
Laminoplasty
offers another treatment
option. This is a method of reconstructing the
bony roof overlying the spinal cord to create
more room. See brochure on laminoplasty for
additional information.
Cervical Deco
mpression and Fusion.
If there is a significant component of compres-
sion along the spinal cord a thorough decom-
pression may be required. In some patients
there is some underlying instability or abnor-
mal posture of the neck, in order to correct
this a cervical fusion from an anterior and/or
posterior approach may be required. Here is a
photograph of a posterior fixation system.
Surgery is intended to halt the progression of
symptoms. These surgical procedures can give
the spinal cord an environment where it can
start to heal.
Surgery is not always indicated in cases of
myelopathy. In certain cases Dr. Pazmiño may
recommend a course of regular observation
along with a course of customized Physical
therapy. It is important to maintain muscu-
lar strength and conditioning while avoiding
atrophy and weakness. For more information
on myelopathy please refer to our website at
www. spinecal .com
SPINAL CORD WTIH MYELOPATHY
HEALTHY SPINAL CORD
SPINAL CORD & FUNCTION
The spinal cord is a long, thin, tubular bundle
of nervous tissue that extends from the brain
and lies within the spinal canal. The spinal cord
is basically the “information highway of the
body”, back and forth between the brain and
the rest of the body.
The cord is responsible for relaying informa-
tion such as touch, temperature, pain, and sig-
nals telling muscles to move. The spinal cord
also regulates your balance, sexual, bowel and
bladder function. Here is a microscopic photo
of a normal healthy spinal cord.
If the spinal canal becomes too narrowed it can
place an undue amount of pressure on the spi-
nal cord. This can cause a disease of the spinal
cord called
Myelopathy
. This is a microscopic
photo of a spinal cord with myelopathy. Notice
the scarring, and disorganized nature of the
cord. It almost appears to be evaporating.