Thoracic Myelopathy

Thoracic myelopathy is a condition in which the spinal cord is compressed in the thoracic spine, the middle part of your back (roughly between your neck and lower back).

What is thoracic myelopathy?

  • “Myelopathy” means spinal cord dysfunction

  • “Thoracic” refers to the mid- to upper back

So, thoracic myelopathy = symptoms caused by pressure on the spinal cord in the thoracic spine.

Your spinal cord is like a major communication highway between your brain and body. When it’s compressed, signals don’t travel properly, leading to problems with movement, sensation, and body control.

Why is thoracic myelopathy important?

The thoracic spinal cord controls:

  • Leg strength and sensation

  • Balance and walking

  • Bladder and bowel function

Because the spinal cord (not just a nerve) is involved, symptoms can be serious and progressive if untreated.

Common symptoms

Symptoms often develop gradually and may include:

  • Back pain (mid or upper back)

  • Numbness, tingling, or weakness in the legs or feet

  • Trouble walking, balance problems, or stiffness

  • Coordination difficulties

  • Loss of bladder or bowel control (a red flag)

Symptoms vary depending on exactly where and how severely the cord is compressed.

Common causes

Anything that narrows the spinal canal or presses on the cord can cause thoracic myelopathy, such as:

  • Herniated or bulging discs

  • Spinal stenosis (narrowing of the canal)

  • Degenerative changes (spondylosis)

  • Tumors

  • Infections or inflammation

  • Trauma or fractures

  • Less commonly, neurological diseases

     

How it’s diagnosed

Clinicians use:

  • Physical and neurological exams

  • MRI (most important test)

  • CT scan or X-rays

  • Sometimes nerve function tests

     

Treatment options

Nonsurgical (for mild cases or symptom control)

  • Physical therapy

  • Bracing

  • Pain or anti-inflammatory medications
    ⚠️ These do not remove the compression, only manage symptoms.

     

Surgical treatment

  • Surgery is often recommended when:

    • Symptoms worsen

    • Walking or bladder/bowel control is affected

    • Imaging shows significant spinal cord compression

Surgery aims to decompress the spinal cord and prevent permanent damage.

What happens if it’s not treated?

If untreated, thoracic myelopathy can:

  • Progress over time

  • Cause permanent nerve damage

  • Lead to severe weakness or paralysis

  • Result in permanent bladder or bowel dysfunction

Early diagnosis and treatment improve outcomes.

When to seek medical care urgently

Get medical attention if you notice:

  • Worsening walking or balance problems

  • New leg weakness or numbness

  • Loss of bladder or bowel control

  • Rapidly worsening symptoms

     

In short:

Thoracic myelopathy is a serious condition caused by spinal cord compression in the mid-back that can affect walking, sensation, and organ control. Early evaluation is crucial to prevent permanent damage.