Key Points about Thoracic Myelopathy 

  • Thoracic myelopathy occurs when the middle area of the spinal cord is compressed.
  • Thoracic myelopathy is diagnosed using imaging tests – such as X-ray or MRI – and electrical studies.
  • The most common treatment for thoracic myelopathy is decompression surgery, though physical therapy and medications may also be used.
Common related conditions
Cervical Radiculopathy Myelopathy Spinal (Vertebral) Compression Fractures

Myelopathy is an injury that occurs due to severe compression to the spinal cord. This compression may result from trauma, congenital stenosis, degenerative disease or a herniated disc. Thoracic myelopathy is when this compression occurs in the middle area of the spine.

Thoracic myelopathy causes 

The possible causes of thoracic myelopathy include:

  • Bone spur
  • Cyst or hematoma in the spine
  • Degenerative spine conditions, such as spinal stenosis (narrowing of the bones of the spine that compresses the spinal nerves)
  • Herniated disc
  • Rheumatoid arthritis in the spine
  • Spinal injury or infection
  • Spinal tumor, including bone cancer

Thoracic myelopathy risk factors

If you have any of the following conditions, your risk developing thoracic myelopathy may increase:

  • Bone cancer or a spinal tumor
  • Herniated disc
  • Rheumatoid arthritis in your spine
  • Spinal stenosis
  • Spine infection
  • Traumatic spinal injury

Thoracic myelopathy symptoms

Signs and symptoms of thoracic myelopathy include:

  • Difficulty with coordination
  • Pain in the neck, arm, leg or lower back
  • Tingling, numbness or weakness
  • Trouble keeping your balance
  • Trouble walking
  • Trouble with fine motor skills, such as holding a pen to write or using a zipper
  • Urinary or stool incontinence

Thoracic myelopathy diagnosis

Your specialist may use the following tests to diagnose your thoracic myelopathy:

X-ray. Your specialist may order an X-ray to rule out any other conditions that can cause similar symptoms.

Magnetic resonance imaging (MRI). Your doctor may order an MRI to obtain a detailed image of your spine and spinal cord.

Electrical tests. Your specialist may order an electrical test – such as an electromyogram or somatosensory evoked potentials – to check how well your nerves are working.

Thoracic myelopathy treatment

Your doctor may recommend one or more of the following treatments for your thoracic myelopathy:

Medication. Your specialist may recommend medications to help relieve pain associated with your thoracic myelopathy.

Physical therapy. You may work with a physical therapist to help you how to more easily complete daily tasks. As part of this, you may need to wear a brace.

Spinal decompression surgery. In this procedure, your specialist removes the cause of your thoracic myelopathy, such as a bone spur or herniated disc.

Laminoplasty. In this treatment for more advanced types of thoracic myelopathy, your specialist widens the space through which your spinal cord passes. This helps to relieve pain and other symptoms.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing a spine specialist for more specialized treatment.