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Myelopathy

Any condition causing pressure on the spinal cord is termed a myelopathy.  This can occur in the cervical spine or thoracic spine. (The spinal cord ends at the lower border of L1 vertebra). Most commonly it is due to spondylosis – degeneration of the intervertebral discs, bony outgrowths (osteophytes) and calcification and thickening of the ligaments which grow and press upon the spinal cord. At first, this process may occur “silently” because the cord is numb. As the myelopathy develops the arms go numb and weak, the hands get clumsy and the legs weak and stiff.  Commonly, it causes difficulty with fine movements in the hands such as doing up buttons and writing or brisk movements in the legs such as running or skipping down stairs.  It is relatively rare. If you have a myelopathy, you may need a more extensive removal of bone from the front of the spine so as to decompress the spinal cord in its central canal.  This type of operation is called a vertebrectomy/corpectomy.

The spinal cord has many spare nerve cells and these can be lost in large numbers before weakness, stiffness or numbness arise.  This silent damage may be costly in future years as these ‘spare’ neurons are there to help you cope with the normal loss of nerve cells that occurs with age. 

Thus, even if recovery follows surgery, a later deterioration may occur as the spinal cord develops its own version of early ‘dementia’.