History
The course of a myelopathy can be very different depending on the cause. A basic distinction is made between an acute and a progressive form. Acute means occurring quickly or suddenly, which is manifested by sudden development of the symptoms.The cause can be, for example, bleeding into the spinal canal after a trauma.
Furthermore, the interruption of the blood supply due to an infarction can lead to an acute myelopathy. Sometimes herniated discs also manifest themselves in the acute form. However, since the myelopathy with a herniated disc usually progresses slowly, it is called a progressive course.
This is also the case with tumors, which usually grow into the spinal canal over time and slowly displace the spinal cord. This leads only gradually to increasing neurological symptoms. Degenerative changes in the bone that grow into the spinal canal also lead to symptoms only in the course of time. This often insidious symptom development is the insidious aspect of the disease. Early diagnosis and therapy are crucial for successful healing.
Specifics of the different localizations
Myelopathy of the cervical spine is known in medical terminology as cervical myelopathy. It is the most common form of myelopathy and often progresses insidiously. The cause is usually compression.
The spinal cord is damaged by a herniated disc in the cervical region. Degenerative joint changes also lead to the formation of new bone (osteophytic attachments). Since the space in the spinal canal is limited, the nerve cell bundles in the spinal cord are also displaced.
Symptoms can be both sensory and motor disturbances, with arms and legs affected. During the clinical examination, the patient complains of discomfort in the arms when his head is passively bent forward. In this case, this is referred to as a positive Lhermitte sign.
Early neurosurgical intervention is the therapy of choice. The faster the diagnosis is made and the patient is given the right therapy, the better the course of the disease. In the case of an acute herniated disc, the chances are not bad that the symptoms will at least largely regress.
Myelopathy in the thoracic spine is known in medical terminology as thoracic myelopathy. The symptoms and course are similar to those of the cervical form. Thus, the symptoms usually appear insidiously.
Sensitivity disorders and muscle weakness in the arms and legs occur. This often leads to an impairment of the gait pattern. Disorders of bladder and bowel emptying are also common.
If the course of the disease cannot be halted, there is a risk of developing a paraplegic syndrome. The disease is treated depending on the cause. In the case of herniated discs or tumors, surgical intervention is often indispensable. Overall, however, thoracic myelopathy is significantly less common than the cervical form.
