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Myelomalacia: Early Diagnosis and Surgery

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Myelomalacia is a condition of the spinal cord. More specific, myelomalacia refers to the ˜softening' of the spinal cord which can occur as a result of a trauma. Also classified as a degenerative condition, the condition can lead to the death of the patient if the abnormally damaged tissue reaches the nerves located between the third and fifth cervical region. In this article, we are going to cover aspects related to early diagnosis and surgery options.

Early Diagnosis of Myelomalacia

As with any condition, early diagnosis can speed up the patient's recovery time and prevent potentially fatal complications. Unfortunately, in myelomalacia, early detection may prove to be somewhat problematic as the condition's symptoms are much too subtle. Still, physicians have noted that regardless of the outcomes, all patients diagnosed with myelomalacia have hypertension. Not much to go on, unfortunately, since at least a dozen other conditions share this symptom.

Myelomalacia's other symptoms include areflexia (sudden movements/jerks of the limbs),  loss of motor functions in the arms and legs, and, as the condition progresses, paralysis. The only methods of diagnosing this disorder, apart from physical examination, are magnetic resonance imaging (MRI) or myelography.

As myelomalacia is commonly associated with trauma, especially when it comes to sports, any hit or blow to the spinal cord could be construed as a prime ˜suspect' for myelomalacia. An MRI scan can quickly detect if any loss of density occurred within the affected spinal segment.

Depending on the case's severity, the doctor can recommend anything from bed rest to steroids in order to counteract inflammation and deal with spasticity and pain. Another treatment option which is being explored at the moment is stem cells. However, although the results look encouraging on paper, the human clinical trial phase has yet to be approved.

If the condition threatens the patient's integrity, the doctor is free to explore surgical options. For more information on myelomalacia's causes and current treatment options, check out this source. There you will also find alternative therapies that can greatly alleviate symptoms before and after surgery.

Surgical Treatment of Myelomalacia

If the case applies, surgery is employed as a last resort to undo some of the damage or to curb the condition's progression. Prior to surgery, an MRI is performed to determine the segment of the spinal cord being blocked by the tissue softening.

With the advent of laparoscopy, spinal decompression surgeries are, generally, minimally invasive. This speeds up the patient's post-op recovery and dramatically reduces the odds of resurfacing. The surgery is performed under general anesthesia. As part of the procedure, the surgeon would proceed with making a small incision over the affected area. The layers of tissue are pulled aside enough for a small camera with instruments to be placed inside the cavity.

Depending on the severity of the injury and the MRI result, the surgeon could apply one or more spinal decompression techniques:

  • Discectomy “ involves the removal of a part or a whole intervertebral disc to relieve the pressure on the adjacent nerve roots;
  • Laminotomy/laminectomy “ this technique involves the whole or partial removal of the lamina, a bone arch that sustains the spinal canal;
  • Foraminotomy/foraminectomy “ the first procedure refers to the broadening of the spinal canal, while the latter involves tissue and bone removal;
  • Osteophyte effacing “ the surgeon will apply this technique to remove bony outgrowths called osteophytes;
  • Corpectomy “ this spinal decompression surgical technique is employed if the case calls for the removal of the vertebra's body and one or more intervertebral discs.

Please bear in mind that spinal decompression surgery in myelomalacia is not without risks. Your surgeon will prompt you before the surgery takes place. The complications associated with this kind of surgery include blood clots, tissue and/or nerve damage, post-operative infection, profuse bleeding, and anaphylactic shock if the patient is allergic to the anesthetic used.

The good news is that spinal decompression surgery for myelomalacia has a success rate of over 80 percent. Furthermore, this high success rate translates into the patient spending no more than 4 to 5 days in the hospital.

Conclusion

Myelomalacia is a degenerative disorder that leads to the softening of the spinal cord. The most common cause of myelomalacia is trauma. Prevention is, perhaps, the patient's first and only line of defense. Early diagnosis is difficult, but not impossible. The condition comes with a symptom associated with many other conditions: hypertension.

Depending on the severity of the injury and the disease's progression likelihood, attending physicians can recommend bed rest, steroids, or surgery to prevent myelomalacia from spreading to the motor nuclei. If left untreated, the patient can develop life-threatening complications. Fortunately, surgery is minimally-invasive and the estimated recovery time is 4-5 days.