Definition

Myeloradiculopathy is a condition that affects the spinal nerve fibers and their branching points.

The term myeloradiculopathy is derived from "myelo," which refers to the nerve fibers, "radiculo," which refers to the origin of the nerve branches, and "pathy," which means pain or disease. If the pain occurs only in the nerve fibers, the appropriate term is "myelopathy," while pain at the nerve branch origin is referred to as "radiculopathy."

Myeloradiculopathy is most commonly caused by compression or pressure on the spinal cord. Continuous pressure can lead to inflammation in both the spinal nerve fibers and their branching points. There are three types of myeloradiculopathy based on the location of the inflammation: cervical myeloradiculopathy, thoracic myeloradiculopathy, and lumbar myeloradiculopathy.

Causes

The basic principle of myeloradiculopathy is inflammation of the spinal nerve fibers and their branching points. However, this condition can also be caused by spinal fractures, infections, tumors, spinal degeneration, and abnormal bone growth in the spine.

Risk factor

Risk factors for myeloradiculopathy include:

• Advanced age
• Female gender
• Spinal tumors
• Lack of physical activity and exercise
• Poor posture during work and exercise
• Carrying heavy loads on the back
• Insufficient calcium intake
• Using inappropriate pillows and mattresses for spinal health
• Herniated nucleus pulposus
• Neurodegenerative diseases like Parkinson's or amyotrophic lateral sclerosis
• Narrowing of the spinal canal

Symptoms

Myeloradiculopathy is classified into three types:

• Cervical Myeloradiculopathy: Inflammation occurs in the cervical spine, where nerve fibers exit the neck. Symptoms include neck pain, shoulder pain, muscle weakness, and numbness radiating from the shoulder to the hand.
• Thoracic Myeloradiculopathy: Inflammation occurs in the upper spine, causing symptoms concentrated on pain and numbness radiating from the spine to the front of the body.
• Lumbar Myeloradiculopathy: Inflammation occurs in the lower spine and is associated with sciatica pain.

General symptoms of myeloradiculopathy include:

• Back pain
• Numbness
• Limb weakness
• Muscle stiffness
• Muscle weakness
• Burning sensation in the spine radiating to the hands, shoulders, or feet
• Decreased bladder or bowel function
• Reduced balance or coordination
• Difficulty performing daily activities like buttoning clothes or picking up small objects
• Changes in gait

Diagnosis

Diagnosis involves a thorough patient interview (anamnesis), physical examination, and supportive tests.

The anamnesis will cover the main complaints, associated symptoms, duration of symptoms, past medical history, current treatments, physical activity, work history, and family medical history.

The physical examination includes general checks of consciousness, blood pressure, pulse, respiratory rate, and body temperature. A specific neurological examination will assess nerve reflexes, motor function, sensory function, facial nerve function, muscle stiffness, and balance.

Supporting tests may include radiological exams like X-rays, CT scans, or MRI of the spine, nerve and muscle function tests like electromyograms, and nerve conduction studies. All tests should be based on the recommendations of a neurologist.

Management

Treatment for myeloradiculopathy depends on the underlying cause and can be broadly divided into non-surgical and surgical approaches.

Non-Surgical Treatment

Non-surgical treatment includes medication to alleviate symptoms, typically for less severe cases. Medications may include pain relievers, muscle relaxants, anti-inflammatory drugs, antibiotics for specific infections, physical therapy to stretch the spinal muscles, lifestyle and activity modifications to improve posture, and weight loss strategies for obese patients. All medications should be prescribed and monitored by a doctor.

Surgical Treatment

Surgery may be necessary if there is significant compression of the spinal nerve fibers and their branching points. The type of surgery is determined by a neurosurgeon and may include discectomy, laminectomy, foraminotomy, spinal fusion, and intervertebral disc replacement surgery. The success of surgery depends on the severity of the condition, patient gender, age, surgical technology used, and duration of symptoms.

Complications

Complications of myeloradiculopathy include:

• Loss of motor function in the affected spinal area
• Persistent neck pain
• Chronic back pain
• Chronic headaches
• Postural changes such as temporary or permanent lordosis or kyphosis
• Formation of abnormal bone growths (osteophytes)
• Permanent nerve damage
• Permanent loss of motor and sensory functions

Prevention

Preventive measures for myeloradiculopathy include:

• Improving posture during work and exercise
• Avoiding heavy loads on the back and ensuring even weight distribution
• Using proper pillows and mattresses for spinal health
• Regular muscle stretching exercises
• Ensuring adequate calcium intake
• Treating diseases that are risk factors for myeloradiculopathy, such as infections, tumors, and herniated nucleus pulposus
• Regular check-ups with a neurologist if there is a history of risk factors
• Avoiding smoking
• Maintaining a healthy weight to prevent obesity

When to see a doctor?

See a doctor if you experience any of the symptoms mentioned above, especially changes in gait, balance, and numbness. You can initially visit a general practitioner for an evaluation. If myeloradiculopathy is suspected and requires further treatment, the general practitioner will provide appropriate care and refer you to a neurologist.

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