Myelopathy is a term that means that there is something wrong with the spinal cord itself. This disease is very different from the radiculopathy that is caused by isolated points of pressure on individual nerve roots. This process does not commonly occur with low back pain because the spinal cord itself ends at about the level of the first and second lumbar vertebral body. From this point on, only nerve roots occupy the spinal canal. However, in certain situations where there is extensive arthritis and stenosis in the upper parts of the lumbar spine, or elsewhere in the cervical and thoracic spine, a patient may develop myelopathy as a result of compression of the spinal cord. This disease is often first detected as difficulty walking due to generalized weakness or problems with balance and coordination.
Myelopathy is most commonly caused by spinal stenosis, which is a progressive narrowing of the spinal canal. In the later stages of spinal degeneration, bone spurs and arthritic changes make the space available for the spinal cord within the spinal canal much smaller. The bone spurs may begin to press on the spinal cord and the nerve roots, and that pressure starts to interfere with how the nerves function normally.
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