What Are Myelopathy and Radiculopathy?

Your spinal cord is a structure that comes out of the brain and runs from your neck down to your lower back. Nerves branch off from your spinal cord to exchange messages between your brain and rest of your body.

• Myelopathy occurs when the spinal cord gets compressed.
• Radiculopathy occurs when a nerve branching off from your spinal cord gets compressed or damaged by surrounding tissue (also known as a “pinched nerve”)

What Do Myelopathy and Radiculopathy Feel Like?

Myelopathy
Symptoms of myelopathy can include:

• Trouble with balance and/or coordination
• Difficulty walking
• Difficulty with fine motor skills, like writing, buttoning your clothing, or using eating utensils
• Pain, tingling, numbness, and weakness in and/or around the affected area, which can be in your:
  • Arms
  • Hands
  • Legs
  • Feet
• Exaggerated and/or abnormal reflexes in extremities

Radiculopathy
Symptoms of radiculopathy can include:

• Sharp pain, tingling, and numbness around the affected nerve, which can be in your:
  • Neck and arms
  • Lower back and legs
  • Chest (less common)
• Difficulty sitting, standing, or moving
• Muscle weakness

What’s Causing My Myelopathy / Radiculopathy?

Causes of myelopathy and radiculopathy are similar. These include:

• Arthritis / bone spurs
• Herniated discs
• Trauma
• Infection 
• Spinal stenosis
• Autoimmune disorders that affect the spine, such as rheumatoid arthritis
• Spinal tumors, cysts, or hematomas

How Can I Treat My Myelopathy / Radiculopathy?

Myelopathy
Myelopathy is a progressive disease, meaning it tends to get worse over time if left untreated.

If your symptoms are mild, your doctor may recommend non-surgical treatments to relieve pain and restore function. These treatments could include:

• Close observation
• Physical therapy
• Over-the-counter pain relievers 
• Corticosteroids

Your doctor may also suggest these treatments if you are a candidate for surgery and need help managing symptoms while you wait.

If your symptoms are severe or if non-surgical treatments do not provide relief, your doctor may recommend surgery. 

Many surgeries performed on myelopathy patients focus on the lamina—the back portion of each vertebra, which are the bones that protect your spinal cord—in an effort to reduce spinal compression. These surgeries include:

• Laminectomy: removes the lamina from the affected vertebrae
• Laminotomy: removes a small section of the lamina from the affected vertebrae
• Laminoplasty: cuts and adjusts the position of the lamina on the affected vertebrae to create more space
• Foraminotomy: enlarges the neural foramen—the channel through which your nerves branch off from your spinal cord—between the affected vertebrae, which often involves removing part of the lamina

If a herniated disc is causing your myelopathy, your doctor may consider one of the following surgeries instead: 

• Discectomy: removes of the damaged portion of the herniated disc
• Disc replacement surgery: removes the herniated disc and replaces it with an artificial disc
• Spinal fusion: fuses affected vertebrae together to prevent them from being able to move, thus reducing or eliminating pain

Radiculopathy
Unlike myelopathy, radiculopathy is a temporary issue that clears up on its own approximately 80% of the time. If you do end up needing treatment, your doctor may recommend:

• Ice or heat on the affected area
• Physical therapy
• Over-the-counter pain relievers or prescription medications
• Steroid injections

Surgery, similar to those performed for myelopathy, is reserved for radiculopathy patients who:

• Fail to improve with the treatments listed above
• Develop functional weakness
• Experience persistent pain