3 percent of individuals with progressive curvature may eventually experience severe problems that can include scoliosis and back pain, spinal problems, and nerve compression causing numbness, weakness, and leg pain.
Thoracic Spine Myelopathy
Thoracic Spine Myelopathy is a disorder that results from severe spinal cord compression, especially in the thoracic region. The spinal cord in this area usually gets compressed due to bulging or herniated discs, bone spurs, and spinal trauma, and thus causes severe pain and discomfort. If you are wondering what could be one of the most effective ways to treat this condition, it is Thoracic decompression surgery.
Thoracic Spine Anatomy
The thoracic spine is the core part of the spine. The spine comprises 33 vertebral bones. And these are stacked one on top of the other with cushioning discs between each vertebra. It consists of 7 cervical vertebrae (neck), 12 thoracic vertebrae (mid back), five lumbar vertebrae (lower back), five sacral bones, and four coccyx bones.
The sacral and coccyx bones are joined together. And they do not help with any movement in the spine. The spine plays a crucial role in smooth movement, maintaining the stability and protection of the delicate spinal cord. Also, this gives symmetry and support to the body.
Causes of Thoracic Spine Myelopathy
Thoracic myelopathy typically develops because of gradual degeneration of the spine. Also, there is compression of the nerve roots and spinal cord that result from the following conditions:
- Spinal stenosis
- Autoimmune disorders: rheumatoid arthritis of the spine
- Hernias, Hematomas, cysts, and spinal tumors, including bone cancer
- Spinal infection, neurological disorders, spinal trauma, inflammatory disease, radiation therapy
- Central disc herniations
- Congenital disorders
With increasing age, arthritic illness, inflammation, bone spurs, and flattened spinal discs between the vertebrae can compress the spinal cord and the nerve roots. Thus, Myelopathy usually develops slowly due to the gradual degeneration of the spine (spondylosis). However, it can also take a severe form or can occur from spine deformity present at birth.
- The common reasons behind myelopathy are degenerative spinal conditions such as spinal stenosis. In this condition, the bony passageways of the spine through which nerve roots and the spinal cord travel narrow.
- Central disc herniations can also compress the spinal cord leading to myelopathy.
- Also, autoimmune disorders such as rheumatoid arthritis in the spine can result in degenerative changes in the vertebrae leading to spinal cord compression and myelopathy.
- Diseases like hematomas, Hernias, cysts, and spinal tumors, for example, bone cancer, may also create compression on the spinal cord leading to myelopathy.
- Severe myelopathy can form quickly from a spinal injury, radiation therapy, neurological disorders, spinal infection, inflammatory disease, etc.
Typically, spinal cord trauma or compression leads to loss of sensation and function and pain or discomfort around the area. Thoracic myelopathy symptoms are:
- Tingling, numbness, or weakness
- Neck, arm, lower back, or leg pain
- Difficulty walking
- Problems with balance and coordination
- Losing control of bowel or urination
- Abnormal or increased reflexes in the extremities
- Problems with fine motor skills
Diagnosis of Thoracic Spine Myelopathy
Accurate diagnosis is necessary for the effective management of thoracic myelopathy. To get a proper diagnosis, you need to have a detailed review of your medical history and a thorough physical and neurological examination as well. Neurological examination plays a significant role in identifying any signs of neurological injury.
Also, it entails proper assessment of reflexes and muscle weakness. Our spine doctors may also recommend different tests to get a detailed view of the spine and spinal canal. It will help evaluate any abnormalities and confirm the diagnosis of thoracic myelopathy accordingly. The recommended tests are:
- Treatment for Thoracic Myelopathy
- X-rays – These will help point out other problems as well.
- MRI scan – It delivers a detailed image of the spine and spinal canal. This procedure can show stenosis areas.
- Electrical tests, such as somatosensory evoked potentials or electromyogram – These will show how effectively your nerves are functioning to deliver sensation and the ability to move your arms and legs. These tests help measure how the stimulation of nerves in different limbs connects through the spinal cord to the brain.
The doctor will discuss the diagnosis with you in different ways. Sometimes, myelopathy adds to other conditions that indicate the association of the spinal cord. For example, an individual may have cervical stenosis with myelopathy or thoracic disc disorder with myelopathy.
On the other hand, if the condition does not involve the spinal cord, your diagnosis will say without myelopathy, for example, displaced lumbar intervertebral disc without myelopathy. In case myelopathy is a complication related to another disease, the doctor may refer to it with regard to that disease. For example, diabetic myelopathy means the spinal cord is damaged because of diabetes. Carcinomatous myelopathy means that the spinal cord is damaged due to carcinoma.
Thoracic Spine Myelopathy Treatment
Doctors usually determine the treatment depending on the reasons for thoracic myelopathy. The treatment includes both non-surgical and surgical methods.
Non-surgical procedures help treat mild thoracic myelopathy types. And surgeons use it to relieve pain and discomfort with the help of bracing, physiotherapy, and medication. These treatments can be helpful in treating mild myelopathy, reducing pain, etc. Thus, you can return to your daily activities fast.
However, the non-surgical approach does not help treat compression. Your symptoms may progress gradually, and sometimes acutely. If you notice a steady progression of your symptoms, consult your doctor asap. Remember that some of the damage can be irreversible even with proper treatment. That is why it’s crucial to stop any progression when figured out in the mild stages.
Surgical Treatment of Thoracic Spine Myelopathy
Thoracic spine decompression surgery is the common surgical treatment used to treat spinal cord compression. Decompression surgery helps take the pressure off the nerve root or spinal cord. Thus, it relieves pain and discomfort. Thoracic herniated disc surgery also plays a crucial role in eliminating herniated discs or bone spurs that often press against the spinal cord.
Your physician may recommend surgery (laminoplasty) to treat advanced thoracic myelopathy that occurs due to stenosis (narrowing of the spinal canal). Laminoplasty is a motion-sparing procedure that provides more space for the spinal cord and nerve roots so that these can relieve abnormal pressure. Also, these can retain flexibility in the compressed area of the spine.
Some patients may not be a candidate for laminoplasty. In that case, decompression and spinal fusion are suitable alternatives. During spinal fusion, surgeons fuse two or more vertebrae together so that they can heal into a single, solid bone. It helps improve painful motion and also restores stability to the spine.
Minimally invasive spine surgery also can be suitable since it involves lower risks and complications. Furthermore, it guarantees a faster recovery because of minimal surgical incisions and reduced trauma to the body, unlike traditional open surgery. While performing this type of surgery, specialists generally use tiny instruments and an endoscope that visually guides the surgery.
This is also called a laminectomy which surgeons perform minimally invasively or with the help of open surgery. Laminectomy is considered safe and highly effective in improving function and quality of life.
Apart from surgeries, exercises and medications too can help improve the condition.
Thoracic Spine Myelopathy Bottomline
If your child is suffering from Thoracic Spine Myelopathy and if you are wondering where to get the best treatment for this, look no further than us. From the initial consultation and diagnosis to treatment and care – we will take care of everything.
We’re here to help STOP THE PAIN
If you are an adult living with scoliosis or have a child with this condition and need a doctor who specializes in orthopedic surgery,
call the Southwest Scoliosis and Spine Institute at 214-556-0555 to make an appointment today.