What Is Myelomalacia?

Myelomalacia is a medical condition in which the spinal cord becomes soft. It is caused by insufficient blood supply to the spinal cord, either as a result of bleeding or because of poor circulation. Myelomalacia most often occurs as a result of injury. The elderly are most at risk for the condition, because of reduced bone density, leading to greater risk of spinal cord injury. Athletes are also at increased risk of spinal cord injury.

Caused by mild to severe spinal cord injury, myelomalacia leads to neurological problems, often related to muscle movement. Often, the onset of the condition is slow and subtle, making it difficult for doctors to catch at an early stage. Myelomalacia may present simply as high blood pressure, for example, and may not be diagnosed until after the point at which it has become inoperable.

While symptoms vary, they may include loss of motor function in the lower extremities, sudden jerking of the limbs, an inability to sense pain, depression, difficulty breathing, and paralysis. The damage can migrate towards the brain in a condition known as ascending syndrome. Myelomalacia can be fatal if it causes paralysis of the respiratory system.

Myelomalacia is diagnosed through one of two imaging techniques, magnetic resonance imaging (MRI) and myelography. Myelography uses a contrast medium injected into the spine to reveal injuries in x-rays. It is more invasive than an MRI, but can also detect injury in some cases in which MRI cannot. Therefore, myelography is typically used as a follow up to MRI when the latter fails to identify the source of pain or injury.

Unfortunately, neurological damage due to myelomalacia is permanent. It can also worsen, as the nerve damage can cause affected muscles to whither. Treatment is focused on preventing further damage. Possible treatments include spinal cord surgery and medication with steroids, which serves to relax spastic muscles, reduce pain, and reduce swelling of the spinal cord.

Stem cell therapy may be used to repair neurological damage caused by myelomalacia in the future, but the therapy is currently experimental and controversial. Those who oppose stem cell research do so mainly on ethical grounds, since stem cells can be cloned or acquired from human fetuses. Recent technology suggests that adult stem cells, which can be harvested from the patient's own body, show promise in treating neurological damage by allowing new, healthy tissue to grow.