Myelopathy is a clinical presentation of diseases affecting the spinal cord. This is to be distinguished from radiculopathy, which are diseases affecting the nerve roots. 

In presentation, spinal cord issues are often more subtle but are often urgent, and if left untreated, may lead to permanent deficit. Myelopathy is an upper motor neuron condition, which includes the central nervous system – spinal cord, brainstem, and brain diseases.

Myelopathy, unlike radiculopathy, often affects higher level integrative functioning before causing weakness or numbness in a particular area. Such high level disturbance often presents as clumsiness, unsteadiness, imbalance, difficulty with coordination of the hands and feet, and difficulty with fine motor activities such as buttoning buttons and writing. 

Myelopathy can be caused from diseases intrinsic to the spinal cord, such as tumors or inflammatory conditions such as MS, neuromyelitis optica, transverse myelitis; as well as compression of the spinal cord or brain stem including stenosis, disc herniations, Chiari malformations. Often, myelopathy arises from the cervical and thoracic spine.

Myelopathy is a clinical presentation in correlating the patient’s symptoms to diagnostic testing. The workup includes in-person clinical evaluation, and we will likely require X-rays and MRI.