Mechanical and cellular processes driving cervical myelopathy

Abstract

Cervical myelopathy is a well-described clinical syndrome that may evolve from a combination of etiological mechanisms. It is traditionally classified by cervical spinal cord and/or nerve root compression which varies in severity and number of levels involved. The vast array of clinical manifestations of cervical myelopathy cannot fully be explained by the simple concept that a narrowed spinal canal causes compression of the cord, local tissue ischemia, injury and neurological impairment. Despite advances in surgical technology and treatment innovations, there are limited neuro-protective treatments for cervical myelopathy, which reflects an incomplete understanding of the pathophysiological processes involved in this disease. The aim of this review is to provide a comprehensive overview of the key pathophysiological processes at play in the development of cervical myelopathy.

Kinematic analysis of cervical spine canal diameter and its association with grade of degeneration

“…To the best of our knowledge, few reports have thus far described the differences between the pathogenetic mechanisms of cervical canal stenosis at different segments using positional MRI [1][2][3][4]. In this study, we investigated the cervical spinal canal diameters changing under positional MRI, and also the relationship between cervical canal diameter changing under positional MRI and degree of degeneration was examined.…”

Effects of propofol or sevoflurane anesthesia induction on hemodynamics in patients undergoing fiberoptic intubation for cervical spine surgery: A randomized, controlled, clinical trial

“…[19202122] Despite these statistically significant differences, both techniques are suitable for clinical use as recorded differences were rarely associated with MAP values below the safety threshold[21] at any time point. The reduction of LV FS and LV ESQ values at T2 in patients who received propofol suggests a reduction of afterload and preload rather than changes in cardiac contractility.…”

Cervical Spondylotic Myelopathy: Pathophysiology and Surgical Approaches

“…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].…”

“…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]. Posterior disc osteophyte were the most common factor to cause narrowing of spinal cord in the elderly [8].…”

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