Martín-Láez R, Pinto-Rafael J I, Carda-Llop J R, Sanz Alonso F, Montiaga-Núñez F, Paternina-Vidal B, Vázquez-Barquero A
Servicio de Neurocirugía [corrected] Hospital Universitario Marqués de Valdecilla, Santander.
Neurologia. 2004 Dec;19(10):738-60.
Cervical spondylotic myelopathy is the most severe consequence of degenerative disease of cervical spine. In this article we perform a bibliographic review, addressing current controversies in its pathophysiology. Present work lines of most groups dedicated to the study of this condition are focused on improving surgical techniques designed for the treatment of this disease. Pathophysiological studies are scarce, and most of our pathophysiological knowledge of cervical spondylotic myelopathy is based in works done in 60s and 70s. Literature of the last decade lacks neurochemichal studies parallel to those existing for acute spinal injury. In the same way, only three prospective clinical trials comparing conservative and surgical treatment have been done, and none of them has demonstrated clear superiority of surgery. Given the high prevalence of this disease, the need for deep knowledge of its pathophysiologic, neurochemichal and molecular basis, and the optimization of surgical treatment is justified. This probably implies the need for prospective randomized trials to determine which patients are going to benefit from surgery.
脊髓型颈椎病是颈椎退行性疾病最严重的后果。在本文中，我们进行了文献综述，探讨其病理生理学方面当前存在的争议。大多数致力于研究这种病症的团队目前的工作方向集中在改进用于治疗该疾病的手术技术上。病理生理学研究很少，我们对脊髓型颈椎病的大多数病理生理学认识都基于20世纪60年代和70年代所做的工作。过去十年的文献缺乏与急性脊髓损伤现有研究并行的神经化学研究。同样，仅进行了三项比较保守治疗和手术治疗的前瞻性临床试验，而且没有一项试验证明手术具有明显优势。鉴于这种疾病的高发病率，深入了解其病理生理、神经化学和分子基础以及优化手术治疗是合理的。这可能意味着需要进行前瞻性随机试验，以确定哪些患者将从手术中获益。
