Myelopathy
Myelopathy is a composite concept for the designation of various chronic lesions of the spinal cord due to pathological processes localized primarily outside of it.
Etiology: cervical osteochondrosis, atherosclerosis, congenital stenosis of the spinal canal, radiation therapy, alcoholism, intoxications, paraneoplastic disorders.
Pathogenesis: chronic ischemia, degenerative changes, mechanical compression; Often a combination of several factors.
Symptoms, course. Most often, the cervical spinal cord is affected. Due to hypersensitivity to ischemia of motor structures, myelopathy with cervical osteochondrosis and atherosclerosis sometimes proceeds with a picture very reminiscent of amyotrophic lateral sclerosis. A similar situation occasionally occurs with carcinomatous neuromyelopathy. In general, the symptomatology is determined by the level of damage and the spinal structures involved in the process. For most myelopathies, the progression is characteristic. The composition of the cerebrospinal fluid is usually normal. An essential role is played by spondylography, which allows, in particular, to reveal a critical decrease in the sagittal diameter of the spinal canal; The most computational computed tomography of the spine and spinal cord. In all cases of doubt, myelography is indicated.
Treatment is symptomatic. With discogenic myelospathy in case of evidence of evidence of compression of the spinal cord - decompressive laminectomy.
The prognosis for recovery is usually unfavorable. However, with the most frequent cervical discogenic myelopathy, surgical intervention can stabilize the process and even lead to a significant improvement.
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