Myelopathy (Spinal Cord Compression)

Houston Methodist spine specialists diagnose and treat myelopathy, a condition that occurs when pressure on the spinal cord affects how it works. Because the spinal cord carries signals between your brain and body, compression can impact how you move, feel and function.

Our multidisciplinary team, including orthopedic spine surgeons and neurosurgeons, works together to identify the cause of your condition and recommend treatment based on your symptoms, health and goals. When appropriate, eligible patients may also have access to clinical trials studying promising new approaches to spine care.

What Is Myelopathy?

Myelopathy occurs when pressure on the spinal cord interferes with its normal function, most often due to age-related changes in the spine. Myelopathy affects the spinal cord itself, while radiculopathy involves irritation or compression of a spinal nerve root. Because it involves the spinal cord, myelopathy is considered a serious condition that can affect movement, coordination and daily function.

Common Causes of Myelopathy

There are many possible causes of myelopathy. Most often, age-related degeneration of the spine results in chronic wear and tear that narrows the spinal canal or places pressure on the spinal cord. Common underlying causes include:

• Cervical spondylosis – age-related degeneration of the spine
• Herniated or bulging disk
• Bone spurs (osteophytes)
• Spinal stenosis
• Ossification of the posterior longitudinal ligament (OPLL)
• Spinal tumors
• Trauma or injury to the spine
• Inflammatory conditions – such as rheumatoid arthritis

Signs & Symptoms of Myelopathy

Recognizing symptoms early can help your doctor diagnose myelopathy and recommend treatment that may prevent further nerve damage.

Myelopathy symptoms often develop gradually and can be mistaken for normal aging. Early evaluation can help prevent further neurological decline.

Weakness in the Hands & Arms

Myelopathy can cause progressive weakness in the hands and arms. You may notice difficulty with fine motor tasks such as buttoning clothing, writing or gripping objects.

Balance & Coordination Problems

Spinal cord compression can disrupt signals to the legs, leading to an unsteady gait, stumbling or a gradual decline in coordination.

Numbness & Tingling

You may experience persistent numbness or tingling in the hands, arms or legs. These symptoms can interfere with daily activities and may signal advancing spinal cord involvement.

Bowel & Bladder Dysfunction

In more advanced cases, myelopathy can affect the nerves that control bowel and bladder function. This symptom requires prompt medical evaluation.

How Myelopathy Is Diagnosed

Diagnosing myelopathy begins with a medical history and neurological exam. Imaging tests — especially MRI — are used to confirm spinal cord compression and identify its cause. Imaging tests help assess the degree of spinal cord compression, and nerve studies may also be used to evaluate symptoms and rule out other neurological conditions.

Your doctor may use one or more of the following tests:

• Magnetic resonance imaging (MRI) – primary diagnostic tool for myelopathy; uses magnets and radio waves to visualize the spinal cord, soft tissue structures and areas of compression.
• X-ray – uses a small dose of radiation to evaluate spinal alignment and identify degenerative changes such as bone spurs or disk space narrowing.
• Computed tomography (CT) scan or CT myelogram – creates detailed cross-sectional images of the spine, especially helpful when MRI isn’t an option.
• Electromyography (EMG) and nerve conduction studies – measures electrical activity in muscles and nerves to help rule out other neurological conditions.