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Myelomalacia : Causes, Symptoms, and Treatment Options for Spinal Cord Softening

What is Myelomalacia?

Myelomalacia is a condition characterized by softening or degeneration of the spinal cord tissue. It often occurs as a result of spinal cord injury or compression, leading to significant neurological symptoms. Understanding the causes, recognizing the symptoms, and exploring the available treatment options is crucial in managing myelomalacia effectively. This article aims to provide valuable insights into the causes, symptoms, and various treatment options for spinal cord damage associated with myelomalacia.

Causes of Myelomalacia

  1. Spinal Cord Injury: Traumatic events such as car accidents, falls, or sports injuries can cause direct trauma to the spinal cord, leading to myelomalacia. The impact or pressure on the spinal cord can result in tissue damage and subsequent softening.(1)
  2. Spinal Cord Compression: Conditions that compress the spinal cord, such as herniated discs, spinal tumors, or spinal stenosis, can impede blood flow and oxygen supply to the spinal cord, causing tissue damage and myelomalacia.
  3. Ischemia: Reduced blood flow to the spinal cord due to conditions like atherosclerosis, blood clots, or arterial dissection can result in inadequate oxygen and nutrient delivery, leading to myelomalacia.
  4. Inflammatory Conditions: Inflammation in the spinal cord caused by autoimmune disorders, infections, or diseases like transverse myelitis can contribute to myelomalacia.

Symptoms of Myelomalacia

The symptoms of myelomalacia can vary depending on the severity and location of the spinal cord damage. Common signs and symptoms include:

  1. Muscle Weakness: Gradual or sudden weakness in the arms, legs, or both, which may progress over time. Weakness may affect coordination, balance, and fine motor skills.
  2. Sensory Changes: Altered sensation, such as numbness, tingling, or loss of sensation in the limbs, trunk, or specific areas of the body.
  3. Pain: Chronic or intermittent pain in the neck, back, or affected limbs. The pain may be sharp, burning, or radiating in nature.
  4. Spasticity: Increased muscle tone and stiffness, resulting in muscle spasms and involuntary movements.
  5. Loss of Reflexes: Diminished or absent deep tendon reflexes, such as the knee or ankle reflexes.
  6. Bladder and Bowel Dysfunction: Difficulty with urinary or bowel control, including urgency, frequency, or incontinence.

Treatment Options for Myelomalacia

  1. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) and pain relievers may be prescribed to manage pain and reduce inflammation. In some cases, muscle relaxants or antispasmodic medications can help alleviate muscle spasticity.
  2. Physical Therapy: A tailored physical therapy program is essential to maintain and improve muscle strength, flexibility, and coordination. Physical therapists can provide exercises, stretches, and techniques to enhance mobility and reduce the impact of muscle wasting.(2)
  3. Assistive Devices: Mobility aids such as canes, walkers, or wheelchairs may be recommended to support movement and independence. Orthotic devices like braces or splints can provide stability and alleviate muscle weakness.
  4. Surgical Intervention: In severe cases, surgical decompression may be necessary to relieve spinal cord compression caused by herniated discs, tumors, or spinal stenosis. The goal is to remove the source of pressure and restore adequate space for the spinal cord.
  5. Rehabilitation: Comprehensive rehabilitation programs that include physical therapy, occupational therapy, and speech therapy can assist individuals in regaining functional abilities, adapting to lifestyle changes, and maximizing independence.
  6. Pain Management Techniques: Depending on the severity of pain, interventions such as nerve blocks, epidural injections, or spinal cord blocks may be considered to help manage pain associated with myelomalacia.
  7. Lifestyle Modifications: Making certain lifestyle changes can help improve overall well-being and manage the symptoms of myelomalacia. This includes maintaining a healthy diet to support muscle function and overall health, managing stress levels through relaxation techniques or therapy, and practicing good posture and body mechanics to minimize strain on the spinal cord.
  8. Emotional Support and Counseling: Dealing with the physical and emotional challenges of myelomalacia can be overwhelming. Seeking support from counselors, support groups, or therapists can provide valuable guidance, coping strategies, and emotional support for individuals and their loved ones.

Recovery and Prognosis of Myelomalacia

The recovery and prognosis of myelomalacia vary depending on the extent of spinal cord damage, the underlying cause, and the individual’s overall health. It is important to note that complete recovery may not always be possible, especially in cases of severe spinal cord injury. However, with early intervention, appropriate treatment, and rehabilitation, individuals can experience improvements in symptoms, functional abilities, and overall quality of life.


Myelomalacia is a condition characterized by the softening or degeneration of the spinal cord tissue, often resulting from spinal cord injury or compression. Understanding the causes, recognizing the symptoms, and exploring the available treatment options is crucial in effectively managing myelomalacia. Early diagnosis, appropriate medical interventions, rehabilitation, and lifestyle modifications can help alleviate symptoms, improve mobility, and enhance overall well-being. Seeking professional medical advice and working closely with healthcare providers are essential for developing a personalized treatment plan to address the specific needs of individuals with myelomalacia. By focusing on a comprehensive approach to treatment and management, individuals can optimize their chances of improving functional abilities and achieving a better quality of life despite the challenges posed by myelomalacia.


  1. De Bonis P, Anile C, Pompucci A, et al. Delayed posttraumatic syringomyelia. J Neurosurg Spine. 2009;11(4):472-486. doi:10.3171/2009.3.SPINE08976
  2. Fehlings MG, Tetreault LA, Wilson JR, et al. A clinical practice guideline for the management of patients with acute spinal cord injury: recommendations on the type and timing of rehabilitation. Global Spine J. 2017;7(3_suppl):231S-238S. doi:10.1177/2192568217703087
  3. Kobayashi S, Yoshizawa H, Yamada S, et al. Clinical analysis of myelomalacia due to cervical injury without major fracture or dislocation. Spinal Cord. 2007;45(9):597-603. doi:10.1038/sj.sc.3102016
  4. Poonnoose SI, Patel A, Gupta R, Singh P, Singh D. Evaluation and management of patients with myelopathy. Indian J Orthop. 2019;53(1):15-25. doi:10.4103/ortho.IJOrtho_343_18
  5. Qian H, Zhang Q, Yuan W, et al. Correlation between MRI features and clinical characteristics of myelomalacia in patients with cervical spondylotic myelopathy. Medicine (Baltimore). 2020;99(10):e19478. doi:10.1097/MD.0000000000019478
Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 17, 2023

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