Myelomalacia is a neurological condition referring to the softening of the spinal cord as a result of hemorrhagic infarction (the bleeding of the spinal cord). Although research into the causes of myelomalacia is still developing, sports-related injuries and old-age as factors are generally seen as the major causes.
However, since myelomalacia is typically diagnosed long after the onset of nerve damage, post-op tests suggest that other signs of the conditions can be easily overlooked.
Before exploring the treatment options, here’s some more information on what is myelomalacia.
Early diagnoses is very important for effective treatment. The disease may not be curable, but proper pain management can make a difference.
The first line of defense against myelomalacia is prevention. Most clinicians agree that repeated blows to the spinal column could trigger bleeding. This is why doctors insist on athletes wearing protective gear during matches.
However, in rare instances, myelomalacia can occur in the absence of mechanical shock to the spinal cord.
Depending on the location and severity, spinal injuries can severely affect the spinal cord’s functionality, ultimately inviting myelomalacia. From a statistical standpoint, myelomalacia is more common in L1-L5 (first to fifth lumbarvertebrae) and C1-C5 (first to fifth cervical vertebrae) injuries.
Understood as a softening or, more precisely, a weakening of spinal cord segments, myelomalacia is a degenerative neurological condition.
Although symptoms may vary, doctors have noted that many people diagnosed with the condition had flaccid paraplegia (total or partial loss of motor functions in the lower part of the body).
Furthermore, myelomalacia has no tell-tale signs. In some cases patients come in with hypertension, but later discovered they have myelomalacia. There are two means of diagnosing myelomalacia: magnetic resonance imagining (MRI), where the specialist assesses the extent of the damage caused by the disease through measuring bone matter density.
Another way of diagnosing myelomalacia is by performing a myelogram. Myelography involves injecting a radiocontrast substance such as iodine, barium, carbon dioxide or water and conducting a series of X-Rays. The substance would ‘illuminate’ the affected area for the physician, thus increasing the diagnostic precision.
Unfortunately, from its onset, the condition progresses a predictable course: after flaccid paraplegia occurs, the patient develops areflexia (suboptimal reflexes), followed by the loss of deep pain perception in the coccyx area.
As the condition progresses, muscular atrophy would ensue, followed closely by intercostal and/or diaphragmatic paralysis. Clinical observations have revealed that myelomalacia ultimately reaches the brain, creating additional neurological deficits.
Death occurs when the damage reaches the phrenic nerves and the motor nuclei, which are located in the area between the third and fifth cervical vertebrae. Myelomalacia is often called an ascending syndrome since it can reach other upper-body regions. Most patients die due to respiratory paralysis.
Treatment Options for Myelomalacia
As far as treatments are concerned, there’s no universal cure for myelomalacia. However, if diagnosed during its early stages, the neurosurgeon may perform a spinal cord decompression operation. Using camera-guided instruments, the surgeon would relieve the strain on the spinal cord produced by an injury.
In advance stage myelomalacia, treatment takes the form of palliation(supportive care, meant to tackle emergent symptoms rather than treat the cause). Although nerve damage is irreversible, surgical procedures in conjunction with drug-based therapies can stem the progression of the condition.
Other symptoms attributed to myelomalacia such as muscle spasticity (jerking of the limbs) can be alleviated with steroids. The same drug regimen can be employed to reduce the spinal cord’s swelling and/or pain.
In terms of palliative care, doctors often recommend chiropractic physical therapy in order to relieve back pain.
The latest research shows that stem cells could be deployed to undo some of the nerve damage produced by the condition. However, the treatment hasn’t left the experimental stage. Moreover, there’s no indication nor guarantee that stem cells can, in fact, alleviate or treat the condition.
Myelomalacia is a rapidly progressing neurological disorder that is often caused by spinal cord injury. Most doctors agree that the only guaranteed way to treat the condition is by preventing it in the first place. If you’ve reasons to suspect that you could have the condition, we recommend that you consult a neurologist for an immediate assessment. The condition’s highly treatable via surgery and medication if it’s caught in the early stages.