Pathophysiology of cervical myelopathy.
BACKGROUND
Cervical myelopathy is a group of closely related disorders usually caused by spondylosis or by ossification of the posterior longitudinal ligament and is characterized by compression of the cervical spinal cord or nerve roots by varying degrees and number of levels. The decrease in diameter of the vertebral canal secondary to disc degeneration and osteophytic spurs compresses the spinal cord and nerve roots at one or several levels, producing direct damage and often secondary ischemic changes.


OBJECTIVE
Clinicians who treat cervical myelopathy cord injuries should have a basic understanding of the pathophysiology and the processes that are initiated after the spinal cord has been injured.


METHODS
Literature review.


METHODS
Literature review of human cervical myelopathy and clinically relevant animal models to further our understanding of the pathological mechanisms involved.


RESULTS
The pathophysiology of cervical myelopathy involves static factors, which result in acquired or developmental stenosis of the cervical canal and dynamic factors, which involve repetitive injury to the cervical cord. These mechanical factors in turn result in direct injury to neurons and glia as well as a secondary cascade of events including ischemia, excitotoxicity, and apoptosis; a pathobiology similar to that occurring in traumatic spinal cord injury.


CONCLUSIONS
This review summarizes some of the significant pathophysiological processes involved in cervical myelopathy.
Baptiste
Darryl C
DC
Division 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.
Fehlings
Michael G
MG
D017209:Apoptosis; D002574:Cervical Vertebrae; D006801:Humans; D007511:Ischemia / Q000209:etiology; D008279:Magnetic Resonance Imaging; D009192:Myelography; D009498:Neurotoxins / Q000378:metabolism; D013116:Spinal Cord / Q000098:blood supply; D013118:Spinal Cord Diseases / Q000209:etiology* / Q000503:physiopathology*; D013122:Spinal Diseases / Q000150:complications* / Q000175:diagnosis; D013314:Stress, Mechanical; D014057:Tomography, X-Ray Computed
D009498:Neurotoxins