Myelomalacia is a spinal cord condition characterized by the softening and death of spinal cord tissue. This neurological disorder can impair nerve function and lead to severe, often progressive, neurological deficits. It can have lasting effects on an individual’s health and quality of life.
What is Myelomalacia?
Myelomalacia is a condition where spinal cord tissue softens and undergoes necrosis, meaning the cells die. It specifically impacts the spinal cord, a bundle of nerves extending from the brain down the back, responsible for transmitting signals between the brain and the rest of the body. The damage can range from minimal to extensive, directly affecting motor and sensory functions.
The softening can occur at any spinal level, though it is often observed in the cervical (neck) and lumbar (lower back) regions. This softening can lead to a loss of spinal cord volume, disrupting normal communication pathways within the central nervous system. The precise location and extent of tissue damage determine the specific functions that become impaired.
Common Signs and Symptoms
The symptoms of myelomalacia reflect neurological deficits resulting from spinal cord damage. Individuals may experience muscle weakness, which can progress to paralysis, often affecting the arms, legs, or both. This weakness can impact coordination, balance, and fine motor skills, making everyday tasks challenging.
Loss of sensation is common, presenting as numbness, tingling, or a complete absence of feeling in the limbs or trunk. Pain, which can be chronic or intermittent, may also occur in the neck, back, or affected limbs. Myelomalacia can also lead to bladder and bowel dysfunction. In severe cases, the condition can progress cranially, leading to respiratory difficulty or paralysis as the damage affects nerves controlling breathing.
Underlying Causes
Myelomalacia develops due to spinal cord injury or conditions that compromise its blood supply. Traumatic events, such as car accidents, falls, or sports injuries, can directly damage the spinal cord, leading to tissue softening. The impact or pressure can result in bleeding within the cord itself.
Ischemia, or insufficient blood flow to the spinal cord, is another cause. Conditions like atherosclerosis, blood clots, or arterial dissection can reduce oxygen and nutrient delivery, leading to tissue damage and myelomalacia. Spinal cord compression from herniated discs, tumors, or stenosis can also impede blood flow, causing tissue damage. Inflammatory conditions, including autoimmune disorders or infections, can also cause myelomalacia by inflaming the spinal cord.
Diagnosis and Outlook
Diagnosing myelomalacia relies on medical imaging and a thorough neurological examination. Magnetic Resonance Imaging (MRI) is the preferred method, as it can visualize the softening or degeneration of spinal cord tissue. On MRI, myelomalacia appears as an area of increased signal intensity on T2-weighted images within the spinal cord, indicating damaged or necrotic tissue.
The outlook varies depending on the underlying cause, severity of damage, and promptness of intervention. Early-stage myelomalacia may show some reversibility, especially if the initial spinal cord injury was not extensive. However, advanced stages with cystic necrosis or atrophy are not reversible. Surgical intervention may address underlying compression and stabilize the area, aiming to prevent further damage. If permanent nerve damage has already occurred, current treatments cannot restore lost function. The prognosis can be poorer for older patients or those with extensive T2 hyperintensity on MRI.