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  • Writer's pictureDr Josh Bonine DC

Does the pain refer or travel down an arm or leg?

Myelopathy: In previous posts, we have discussed spinal cord compression, where a herniated disc pushes into the spinal cord and the cord is pressed against the back of the spinal canal (see left picture). This “pincer” action on the spinal cord can cause serious neurological consequences as a result of trauma. Should your client have neurological deficits as a result of a disc herniation distal to the level of lesion (see below picture where the outer shaded area in the arm is affected), this is called a myelopathy.

A myelopathic finding is one of the most significant insults to the spinal cord resulting is an immediate surgical consultation and often surgery is the only solution to the injury. Distal to the level of lesion means that if the herniation is in the neck, the problem can be in the arms or legs (anywhere below the herniation). However, if the herniation is in the mid to lower back, the problem in the arms cannot be from a myelopathy because the symptoms are above the problem area. Remember, this cannot happen in the lumbar spine because there is virtually no spinal cord in the lumbar region.


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