Comprehensive Myelopathy – Spinal Cord Surgery
Myelopathy is a condition where there is a reduction in spinal cord activity due to trauma or deterioration of the spine. Its purpose is to relieve symptoms of pressure on the spinal cord or decompression. Surgery is suggested when the nonsurgical treatments are not working longer and the progression of the disorder leads to swelling in the spinal cord together with neurological changes such as:
- Weakening of arms and legs.
- Numbed hands.
- Difficulties with motor skills.
The spinal cord contains bones, ligaments, joints, and muscles. The spinal cord is a group of nerve fibers attached to the brain and the brain stem. This group facilitates effective communication between the brain and the body.
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Types of Myelopathy
- Cervical Myelopathy – This is the most common type of myelopathy. It takes place in the neck.
- Thoracic Myelopathy – It happens in the central part of the spine. The spinal cord becomes compressed due to swelling or herniated discs, spinal trauma, or bone spurs.
- Lumbar Myelopathy – In certain conditions, where the spinal cord is partially or completely fixed, as opposed to a normal spinal cord that finishes at the top of the lumbar spine.
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Causes of Myelopathy
Over the years, our spines lose their water content and over time, this creates pressure on the spine. Apart from this, in the case of age-related spine deterioration, various factors can cause myelopathy such as:
- Bone spurs.
- Tumors that could be benignly compressing the spinal cord.
- Trauma like a motor accident or sports injury.
- A fracture that is dislocated.
- Autoimmune diseases
- Congenital abnormalities.
Some of the other factors that could increase the risk of myelopathy include:
- Alcohol abuse.
- Lack of exercise.
- Take part in major sports like football or gymnastics.
- Physical labor involves repetitive and strenuous movements.
- Heavy objects are lifted improperly.
Symptoms of Myelopathy
The severity and location of spinal problems determine the symptoms. Symptoms will progress and intensify over time. Some of the symptoms include:
- Trouble breathing.
- Pain in the shoulders and arms.
- Sensations like tingling, pins, and legs.
- Difficult to walk due to swollen legs and the inability to move quickly.
- Difficulty writing.
- Muscle weakness.
- Difficult to bend or turn your neck or back.
- Irregular spasmodic movements.
- Problem with hand-eye coordination.
- Changes in sexual functioning.
- Bowel or bladder complications.
- Fatigue or disorientation in the limbs.
- A feeling of shocked or electrified limbs.
- Physical examination of the spine and body.
- MRI Scan
- CT Scan
- Electromyogram or somatosensory.
Treatment of Myelopathy
Treatment depends on the causes. In some cases, some treatments may be capable of giving relief from symptoms or reducing the growth of degeneration of the deformity. There are two types of treatment. It includes:
- Neurological Myelopathy treatment – It involves physical therapy, medication, and energizing. It is generally used for moderate myelopathy whose motive is to decrease pain and return to daily activities. This treatment does not eliminate restrictions. Symptoms will grow slowly and gradually worsen in some cases. In some cases, myelopathy is permanent after treatment, which means it is essential to notice early and gradual progression, which is found to be moderate.
- Surgical Myelopathy Treatment – This treatment helps to relieve pressure on the spinal cord. Surgery is a common procedure. Bone spurs or herniated discs may also be eliminated if they can cause myelopathy. Several surgical procedures are available for those with progressive neurologic change with severe or persistent spinal cord swelling or severe or disabling pain. Minimally industrial procedures may frequently be a better choice than open surgery because it reduces the run of complications and quicker result.
- A complete physical examination of your body.
- Taking diagnostic tests.
- Inform your doctor of all your medical treatments.
- This type of surgery depends on your general health, its type, and the nature of the problem.
- You will be asked to quit smoking if you are currently doing it.
- You will be asked to lose some weight if you’re overweight.
- You will be asked to do different forms of exercise.
- Changes in your lifestyle such as eating a healthy diet and living a healthy life.
- You may need to undergo hot and cold treatments and injections.
- You will be asked to take oral medication as per your doctor’s prescription.
- You will require an empty stomach for 8 – 12 hours.
- You will be prescribed general anesthesia to prevent pain.
- The surgeon cuts into the infected area.
- Depending on the type of myelopathy, the surgeon may perform front-of-the-neck surgery or, in some cases, both.
- A spine fusion is performed where a bone implant is used to connect vertebrae.
- It is possible to use an “enclosure” to support spinal fusions between vertebrae using screws and rods.
- A laminectomy procedure may be performed to eliminate the bony arch at the backside of the spinal canal together with bone spurs and ligaments that shorten the spinal cord.
- A bone graft may follow the procedure.
- Laminoplasty is another procedure where the edges of the spinal cord are reduced on one side and then cut off on the other side. This is done to make it flexible and enlarge the space for the spinal cord.
- The cut is closed and a bandage is applied to the area.
- Stay in the hospital for at least one or two days. However, the length depends on the recovery process of the patient.
- Following your surgery, a tube may be attached to your spine to take any blood or fluid.
- You may have difficulty swallowing some food for several days. Take light food that can be swallowed easily in postoperative conditions.
- You may also have a rough voice based on the type of surgery.
- You are required to put on a soft or stiff collar from time to time.
- You will be prescribed medications if you feel pain.
- Your surgeon may recommend a therapist.
Risks and Complications
Every surgery has some risks and complications. This surgery also has some complications. It may include:
- Nerve injury
- Spinal injury
- Esophageal injury
- Difficulty breathing.
- The decline in disc levels above or below surgery.
- Complications related to bone graft and spinal graft.
- Injury to the vertebral artery.
- Wound breakdown.
Factors affecting the cost of Myelopathy Spine Surgery
The cost of myelopathy starts at $6500. Factors that affect the cost include:
- Location of the hospital.
- Choice of hospitals.
- Type of procedure.
- Surgeon’s fee.
- Diagnostic tests.
- Duration of stay.