Myelopathy? Stenosis?

[maye1]

Hi

Can someone please explain the difference between (cervical) stenosis and myelopathy? Confused by mixed messages from practitioners; would appreciate insight from someone who is experiencing either/both firsthand.

Thanks!

[Hidden]

Hi there. Thank you for your question it's really good one because it does get confusing at times. Cervical Stenosis is basically the pinching that occurs to your spinal cord due to either a slipped disc or osteophytes which are extra bone formations on your spinal column or for some people it can be something called OPLL which is ossification of the posterior longitudinal ligament. Some people have a congenitally narrow spinal canal so they are actually born with a narrow spinal canal and that can bring on symptoms especially if they start to develop things like generator disc disease or osteophytes but sometimes just by flexion and extension of their neck. Myelopathy is the disease that you end up with as a consequence of the stenosis. Now the thing with myelopathy is it can degenerate and it's really important that if you are displaying any signs of clumsiness, pains particularly electric shock type pains, problems with walking & balance or bowel and bladder problems that you seek urgent attention because if it gets to that stage it means that the spinal cord is under threat and it's not going to resolve on its own. I hope this clarifies things for you. If you need be get back in touch, please do & if you're not already a member of myelopathy support on Facebook that's also a good place to go for help & support as we are affiliated with them. We arevalso affiliated with myelopathy.org - the first charity devoted myelopathy. Hugs.

[Hidden in reply to Hidden]

*degenerative disc disease

[maye1 in reply to Hidden]

Hey,

Thanks for your response. That’s what Ive read and so I’m confused - I’m having all those symptoms that you listed but MRI report states stenosis without myelopathy. Is this contradiction common?

Thanks

[Hidden in reply to maye1]

Hi Maye1. I think the idea is that stenosis leads to Myelopathy if it’s a degenerative type, rather than the type that you might be born with or develop as a static structural abnormality for some reason?

I seem to have L5/S1 herniated disc causing some compression by narrowing the tunnel that the sacral nerve runs through - causing slight compression. This is one of a few things that can cause Cauda Equina - which I’m guessing is one type of Myelopathy and also a medical emergency.

I have degenerative disc disease which is now described as significant and the impact on my peripheries and balance certainly is. I’ve gathered from online research that mine is more about case of radiculopathy - but hasn’t reached the stenosis or myelitis stages yet. “Yet” being the key word here from my perspective!

I’m seeing a neuro physio next week so hoping she will be able to shed more light on things:

“C5/6: there is broad based moderately large left paracentral and left foraminal disc extrusion projecting into the left exit foramen and causing significant narrowing. The right exit foramen is patent

C6/7: Broad based posterior central disc protrusion with an annular tear which is abutting and slightly flattening the cord in the anterior aspect but there is no obvious foraminal stenosis on either side.

C7/T1: No significant abnormality.

The cord returns normal signal. Normal cranocervical junction.

Opinion: Significant degenerative disc disease involving C5/6 and C6/7. Please correlate clinically”

[maye1 in reply to Hidden]

Hey Twitchy,

Thanks for your response. Both physiatry and neuro were adamant that this in no way is due to disc herniations - I have stenosis without myelopathy. Physiatry explained it as the depth of compression and that neuro overreacted telling me I was at risk for paralysis. It’s not my spine. I think I already knew that. Ruled that out.

Hope your new PT has some helpful exercises for you. I’ve been doing mine. It’s good to keep moving when you can:). Let me know how it turns out.

[Hidden in reply to maye1]

I think mine is the opposite to yours then? I have 3 discs affected (no MRI done of my thoracic spine though) - one in lumbar and two in cervical but so far no spinal stenosis thankfully, just foraminal narrowing into left arm and leg.

I haven’t spoken to any doctor or the neuro PT yet about any of this so haven’t the foggiest if physio will be enough or not. I think I’m very complicated due to non length dependent presumed small fibre neuropathy. So I keep being passed about and told it’s “just” this or that by people who aren’t actually qualified to determine this. None of it feels at all “just” to me of course!

I have read a bit about Stenosis and it isn’t always caused by degeneration/ Myelopathy is it? Sometimes it can be hereditary or develop in isolation or some are even born with it I believe? But I am very new to all this myself. I think most of my symptoms are related to inflammatory small fibre neuropathy and autonomic dysfunction and the spinal issues, including some flattening of cord (???!), are probably just the icing on the cake. X

[maye1 in reply to Hidden]

Hey-

Well from what I’m learning - stenosis is common as people get older. It’s narrowing of the canal (can be due to disc herniations). If it was the cause of my symptoms I’d have been booked for surgery. I think it’s something to be mindful of and do exercises to try to prevent progression, but it’s not the problem. For me, anyways.

[Hidden in reply to maye1]

Nor for me apparently. I guess it could become one given I have at least 3 herniated discs protruding into my spine though. But, like you, surgery is only something I’d consider if it was definitely needed and going to help some of my symptoms.

[Neckback]

Myelopathy = spinal cord compression, Stenosis = the narrowing of your foramen(passage) impacting on your spinal cord