Understanding Myelopathy | Chiropractic Education

Lumbar disc disorder with myelopathy refers to a condition affecting the lower spine that results in compression of the lower portion of the spinal cord. This compression can lead to significant neurological symptoms and impact a person's quality of life. In this comprehensive guide, we'll explore what myelopathy is, its causes, symptoms, and potential treatment options to help those suffering from this condition better understand their diagnosis.

Myelopathy Meaning

Myelopathy is a medical term that describes any neurological deficit related to the spinal cord. When we specifically talk about myelopathy, we're referring to damage or compression of the spinal cord that disrupts normal nerve function. This condition can occur in different regions of the spine, with lumbar myelopathy affecting the lower back area.

The lumbar spine consists of five vertebrae (L1-L5) located in the lower back between the thoracic spine (upper back) and the sacral region (base of the spine). When disc problems in this area lead to spinal cord compression, the resulting condition is termed lumbar disc disorder with myelopathy.

Different Types of Myelopathy

Myelopathy can be classified into several types depending on the underlying cause:

* Compressive myelopathy: Results from pressure on the spinal cord due to conditions like herniated discs, spinal stenosis, or tumours

* Carcinomatous myelopathy: Spinal cord deterioration associated with cancer

* Radiation myelopathy: Spinal cord damage resulting from radiation therapy

* Disease-related myelopathy: When spinal cord damage occurs as a complication of another condition (e.g., diabetic myelopathy)

Intervertebral Disc Rupture and Myelopathy

One of the primary causes of lumbar myelopathy is intervertebral disc rupture or herniation. The intervertebral discs are cushion-like structures between vertebrae that act as shock absorbers for the spine. Each disc has a tough outer layer (annulus fibrosus) and a soft, gel-like centre (nucleus pulposus).

When a disc herniates or ruptures, the inner gel-like material pushes through the outer layer and can press against nearby nerves or the spinal cord itself. In the lumbar region, this pressure can affect the conus medullaris (the tapered lower end of the spinal cord) or the cauda equina (a bundle of nerve roots resembling a horse's tail), leading to myelopathy.

Myelopathy Symptoms: Recognising the Warning Signs

Recognising the symptoms of lumbar disc disorder with myelopathy is crucial for early diagnosis and treatment. Symptoms can vary depending on the location and severity of spinal cord compression but often include:

Sensory and Motor Symptoms

* Numbness or tingling in the legs and feet

* Weakness in the lower extremities

* Difficulty walking or maintaining balance

* Changes in coordination

* Muscle spasms in the legs

Pain and Discomfort

* Lower back pain that may radiate to the legs

* Pain that worsens with movement

* Discomfort that may increase when standing or sitting for extended periods

Bladder and Bowel Issues

* Urinary urgency or retention

* Bowel dysfunction

* In severe cases, incontinence

These symptoms typically develop gradually as the condition progresses, though sudden onset is possible with acute disc herniation. If you experience any combination of these symptoms, especially bladder or bowel issues, seek immediate medical attention as these could indicate a serious condition requiring urgent intervention.

Causes of Lumbar Disc Disorder with Myelopathy

Understanding the causes of this condition can help with both prevention and treatment planning. Several factors can contribute to the development of lumbar disc disorder with myelopathy:

Age-Related Degeneration

The most common risk factor is age-related degeneration of the intervertebral discs. As we age, the discs gradually lose water content and become less flexible, making them more prone to herniation or rupture. When this occurs in the presence of spinal stenosis (narrowing of the spinal canal), the risk of myelopathy increases significantly.

Other Contributing Factors

Several other factors can increase the risk of developing lumbar disc disorder with myelopathy:

* Excess body weight: Places additional stress on the lumbar spine

* Diabetes: May accelerate disc degeneration through changes in blood supply

* Cigarette smoking: Reduces blood flow to discs and accelerates degeneration

* Genetic predisposition: Family history of disc disorders

* Occupational factors: Jobs requiring heavy lifting or prolonged sitting

* Physical trauma: Accidents or injuries to the spine

Diagnosis of Lumbar Spine Myelopathy

Proper diagnosis is essential for effective treatment of lumbar disc disorder with myelopathy. The diagnostic process typically involves:

A thorough medical history and physical examination are the first steps in diagnosis. Your healthcare provider will assess your symptoms, review your medical history, and perform tests to evaluate your neurological function, including:

* Reflexes

* Muscle strength

* Sensory function

* Gait and balance

Treatment Options for Myelopathy

Chiropractic treatment plays a significant role in the conservative management of spinal conditions. Skilled chiropractors use targeted, non-invasive spinal adjustments and mobilisation techniques to improve spinal alignment, relieve nerve pressure, and restore function. Chiropractic care may also include soft tissue therapy and tailored exercise programmes to support spinal health and reduce inflammation.

Chiropractic treatment is particularly beneficial for:

* Alleviating lower back pain and muscle tension

* Improving posture and spinal biomechanics

* Enhancing mobility and coordination

Key Takeaways

Lumbar disc disorder with myelopathy is a serious condition that requires proper medical attention. Understanding the symptoms, causes, and treatment options can empower patients to seek appropriate care and actively participate in their recovery process. If you're experiencing symptoms that suggest myelopathy, consult with a healthcare professional who specialises in spine disorders for a comprehensive evaluation and personalised treatment plan.

Early intervention is key to preventing permanent neurological damage and maintaining quality of life. With advances in both conservative and surgical treatments, many patients with lumbar disc disorder with myelopathy can experience significant improvement and return to their normal activities.