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Degenerative Cervical Myelopathy: Pathophysiology and Current Treatment Strategies.

作者信息

Choi Sung Hoon, Kang Chang-Nam

机构信息

Department of Orthopaedic Surgery, Hanyang University College of Medicine, Seoul, Korea.

出版信息

Asian Spine J. 2020 Oct;14(5):710-720. doi: 10.31616/asj.2020.0490. Epub 2020 Oct 14.


DOI:10.31616/asj.2020.0490
PMID:33108837
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7595811/
Abstract

Chronic compression or ischemia of the spinal cord in the cervical spine causes a clinical syndrome known as cervical myelopathy. Recently, a new term "degenerative cervical myelopathy (DCM)" was introduced. DCM encompasses spondylosis, intervertebral disk herniation, facet arthrosis, ligamentous hypertrophy, calcification, and ossification. The pathophysiology of DCM includes structural and functional abnormalities of the spinal cord caused by static and dynamic factors. In nonoperative patients, cervical myelopathy has a poor prognosis. Surgical treatments, such as anterior or posterior decompression accompanying arthrodesis, arthroplasty, or laminoplasty, should be considered for patients with chronic progressive cervical myelopathy. Surgical decompression can prevent the progression of myelopathy and improve the neurologic status, functional outcomes, and quality of life, irrespective of differences in medical systems and sociocultural determinants of health. The anterior surgical approach to the cervical spine has the advantage of removing or floating the intervertebral disk, osteophytes, and ossification of the posterior longitudinal ligament that compress the spinal cord directly. The posterior surgical approach to the cervical spine is mainly used for multisegment spinal cord compression in patients with cervical lordosis. In this review article, we addressed the pathophysiology, clinical manifestations, differential diagnosis, and treatment options for DCM.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35de/7595811/90d2beb78d42/asj-2020-0490f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35de/7595811/0ca88ff93298/asj-2020-0490f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35de/7595811/90d2beb78d42/asj-2020-0490f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35de/7595811/0ca88ff93298/asj-2020-0490f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35de/7595811/90d2beb78d42/asj-2020-0490f2.jpg

相似文献

[1]
Degenerative Cervical Myelopathy: Pathophysiology and Current Treatment Strategies.

Asian Spine J. 2020-10

[2]
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[3]
Degenerative Cervical Myelopathy: A Spectrum of Related Disorders Affecting the Aging Spine.

Neurosurgery. 2015-10

[4]
A Comparative Study of Anterior Decompression With Fusion and Posterior Decompression With Laminoplasty for the Treatment of Cervical Spondylotic Myelopathy Patients With Large Anterior Compression of the Spinal Cord.

Clin Spine Surg. 2017-10

[5]
Surgical outcome and prognostic factors of anterior decompression and fusion for cervical compressive myelopathy due to ossification of the posterior longitudinal ligament.

Spine J. 2015-5-1

[6]
An analysis of factors causing poor surgical outcome in patients with cervical myelopathy due to ossification of the posterior longitudinal ligament: anterior decompression with spinal fusion versus laminoplasty.

J Spinal Disord Tech. 2007-2

[7]
Laminectomy and posterior cervical plating for multilevel cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament: effects on cervical alignment, spinal cord compression, and neurological outcome.

Neurosurgery. 2003-5

[8]
Long-term results of double-door laminoplasty for cervical stenotic myelopathy.

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[9]
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JMIR Form Res. 2023-9-12

[10]
Comparison of Outcomes of Surgical Treatment for Ossification of the Posterior Longitudinal Ligament Versus Other Forms of Degenerative Cervical Myelopathy: Results from the Prospective, Multicenter AOSpine CSM-International Study of 479 Patients.

J Bone Joint Surg Am. 2016-3-2

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[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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J Clin Med. 2024-11-25

本文引用的文献

[1]
Cervical Disc Replacement: Trends, Costs, and Complications.

Asian Spine J. 2020-10

[2]
Esophageal Perforation after Anterior Cervical Spine Surgery.

Asian Spine J. 2019-12

[3]
The Role of Vitamin B in the Management and Optimization of Treatment in Patients With Degenerative Cervical Myelopathy.

Global Spine J. 2019-5

[4]
Cervical spondylotic amyotrophy: a systematic review.

Eur Spine J. 2019-4-29

[5]
Mimickers of Cervical Spondylotic Myelopathy.

JBJS Rev. 2018-10

[6]
A novel anterior decompression technique (vertebral body sliding osteotomy) for ossification of posterior longitudinal ligament of the cervical spine.

Spine J. 2018-2-26

[7]
The Natural History of Degenerative Cervical Myelopathy.

Neurosurg Clin N Am. 2018-1

[8]
Neurologic Complications in Managing Degenerative Cervical Myelopathy: Pathogenesis, Prevention, and Management.

Neurosurg Clin N Am. 2018-1

[9]
Comparison of Outcomes for Anterior Cervical Discectomy and Fusion With and Without Anterior Plate Fixation: A Systematic Review and Meta-Analysis.

Spine (Phila Pa 1976). 2018-4-1

[10]
Multilevel posterior foraminotomy with laminoplasty versus laminoplasty alone for cervical spondylotic myelopathy with radiculopathy: a comparative study.

Spine J. 2017-9-4

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