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Pathophysiology of cervical myelopathy
Darryl C Baptiste1, Michael G Fehlings
1Division of Cell and Molecular Biology, Toronto Western Research Institute and Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
The Spine Journal : Official Journal of the North American Spine Society
|November 14, 2006
Summary
Cervical myelopathy, often caused by spinal stenosis, involves cord compression leading to neuronal damage and secondary injury cascades. Understanding these pathological mechanisms is crucial for effective clinical management of spinal cord injuries.
Area of Science:
- Neurology
- Spinal Cord Injury Research
Background:
- Cervical myelopathy involves compression of the cervical spinal cord or nerve roots, commonly due to spondylosis or ossification of the posterior longitudinal ligament.
- Degenerative changes like disc degeneration and osteophytic spurs reduce vertebral canal diameter, causing direct damage and ischemic changes to the spinal cord.
Purpose of the Study:
- To provide clinicians with a fundamental understanding of the pathophysiology and post-injury processes in cervical myelopathy.
- To elucidate the mechanisms underlying spinal cord injury in the context of cervical myelopathy.
Main Methods:
- A comprehensive literature review was conducted.
- The review included studies on human cervical myelopathy and relevant animal models to explore pathological mechanisms.
Main Results:
- Pathophysiology involves static factors (stenosis) and dynamic factors (repetitive injury) leading to cervical cord damage.
- Mechanical factors trigger direct neuronal and glial injury, initiating secondary events like ischemia, excitotoxicity, and apoptosis.
- The observed pathobiology mirrors that of traumatic spinal cord injury.
Conclusions:
- This review consolidates key pathophysiological processes implicated in cervical myelopathy.
- Understanding these mechanisms is vital for advancing treatment strategies for cervical myelopathy.
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