Suggest Myelomacia Treatment?

Posted on Thu, 22 Aug 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 22 Aug 2013 Answered on

Wed, 11 Sep 2013 Last reviewed on

Question : Myelomacia treatment.

Answered by Dr. Sudhir Kumar (1 hour later)

Brief Answer:
Initial treatment is physiotherapy and medical.

Detailed Answer:
Hi,

Thank you for posting your query.

Myelomalacia is an MRI finding, where a part of spinal cord appears hyperintense (white in clour) on T2Weighted sequence. This represents an area of spinal cord, which is partly damaged due to the spinal stenosis, and compression of the spinal cord.

The symptoms include neck pain, tingling and numbness of arms, weakness of arms, etc.

Initial treatment includes physiotherapy, with neck extension exercises and use of soft cervical collar.

For pain and tingling, medications include pregabalin or gabapentin.

Surgery may be required in very severe cases of spinal cord compression.

I hope it helps. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (4 hours later)

there are doctors and clinics in South XXXXXXX that claim they can cure and reverse myelomalacia with stem cells taken from my bone marrow for less than $8,000.00. Laser Spine Institute tell me they can relieve the pressure with a 1/2 incision but they don't mention myeolamacai, just work the area(s) where nerves are in stenosis and relief from edema. There's fluid building in my neck and upper back. Approximate cost $20,000.00. I have read on the internet that the disease eventually results in death. It said stem cell surgery is the only cure, and actually reverses any damage. I called Gladstone institutes in San Francisco and spoke with Dr. Shinya Yamanaka's Administrative, Karena Essex (415-734-2547). according to her, there is no one in the US that can do spinal cord operations requiring stem cells. I'm totally confused about the best thing to do. Ive been in pain for over 8 Years. the neurosurgeon told me it was urgent and I had a no more than a year to live. he wanted to cut my throat and screw in a metal plate. I had no Insurance, but plenty of responsibilities so I said no. Now that I have the financial means, I need to know what the best route for me is.What should I do? - Pretend it's happening to you.
what kind of treatment do I need? history was sent earlier with a what should I do question.
I am past initial treatment and have a severe case. What are my options at this point?

Answered by Dr. Sudhir Kumar (20 minutes later)

Brief Answer:
Surgery is the option at this stage.

Detailed Answer:
Thank you for getting back with more details.

In my opinion, stem cell treatment for spinal cord myelomalacia can be at best described as experimental and there is no hard evidence supporting its use. Also, FDA has not approved this indication of stem cell treatment. So, it is not possible for someone to claim a cure for myelomalacia with stem cell treatment.

Also, as of today, myelomalacia is irreversible, as it indicates damage to nerves in the spinal cord, and nerves in the spinal cord do not regenerate by any means.

The current accepted treatment for severe spinal stenosis leading to myelomalacia is surgery. Whether the fixation with screws is required or not, depends on the MRI picture of the bones (better to do if bones are weak), age of patient and surgeon's preference.

There is no truth in that myelomalacia leads to death. I have seen about 500 cases of myelomalacia so far, and none have died.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar