Ren Zhen-Xiao, Xu Jing-Hui, Cheng Xing, Xu Gui-Xing, Long Hou-Qing
Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology/Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
Neural Regen Res. 2023 Apr;18(4):790-796. doi: 10.4103/1673-5374.353485.
Cervical spondylotic myelopathy is the main cause of non-traumatic spinal cord injury, with chronic static and/or dynamic compressive spinal cord injury as the unique pathogenesis. In the progression of this condition, the microvascular network is compressed and destroyed, resulting in ischemia and hypoxia. The main pathological changes are inflammation, damage to the blood spinal cord barriers, and cell apoptosis at the site of compression. Studies have confirmed that vascular regeneration and remodeling contribute to neural repair by promoting blood flow and the reconstruction of effective circulation to meet the nutrient and oxygen requirements for nerve repair. Surgical decompression is the most effective clinical treatment for this condition; however, in some patients, residual neurological dysfunction remains after decompression. Facilitating revascularization during compression and after decompression is therefore complementary to surgical treatment. In this review, we summarize the progress in research on chronic compressive spinal cord injury, covering both physiological and pathological changes after compression and decompression, and the regulatory mechanisms of vascular injury and repair.
脊髓型颈椎病是非创伤性脊髓损伤的主要原因，其独特的发病机制为慢性静态和/或动态压迫性脊髓损伤。在这种疾病的进展过程中，微血管网络受到压迫并被破坏，导致缺血和缺氧。主要病理变化为炎症、血脊髓屏障受损以及压迫部位的细胞凋亡。研究证实，血管再生和重塑通过促进血流和有效循环的重建，以满足神经修复所需的营养和氧气需求，从而有助于神经修复。手术减压是这种疾病最有效的临床治疗方法；然而，在一些患者中，减压后仍存在残留的神经功能障碍。因此，在压迫期间和减压后促进血管再通是手术治疗的补充。在这篇综述中，我们总结了慢性压迫性脊髓损伤的研究进展，涵盖了压迫和减压后的生理和病理变化，以及血管损伤和修复的调节机制。
