Cervical Spondylotic Myelopathy: Pathophysiology, Clinical Presentation, and Treatment

Abstract

Age-related changes in the spinal column result in a degenerative cascade known as spondylosis.

Cervical Spondylotic Myelopathy: Pathophysiology and Surgical Approaches

“…The mechanical factors are classified further into static and dynamic mechanical factors [1][2][3][4][5][6].…”

“…This abnormal structure can directly compress the spinal cord and cause myelopathy [1][2][3]7]. The static factors include osteophyte formation, hypertrophy of the flavum ligament, ossification of posterior longitudinal ligament (OPLL), disc herniation, congenital canal stenosis, kyphosis, and subluxation [1,2,5,6].…”

“…The dynamic factors are abnormal and repetitive motions of the cervical spine [1,3,6,7]. The dynamic factors combined with the static factors can severely injure the spinal cord [1,2,5].…”

Posterior Osteophyte Evolution and its Impact in Cervical Spondylosis: A Literature Review

“…This narrowing of the sagittal diameter occurs due to the development of the posterior osteophytes which projects into the cervical spinal canal causing indentation over the spinal cord. As such the diagnosis of CSM requires consideration of history, physical examination and imaging studies for each individual patient [43].…”

“…Oshima et al [49] have suggested that 62% of patients with mild CSM will not deteriorate or undergo surgery at 10 years. But systematic review of literature by Lebl et al [43] suggest a mixed course with many patients having quiescent disease for long periods of time while others experiencing a slow, stepwise decline. Thus review of literature shows that the clinical course of cervical myelopathy is variable and that conservative management may result in stability or improvement of symptoms in the majority of the patients with mild symptoms [50][51][52][53].…”