title: Cervical spondylotic myelopathy: current state of the art and future directions.
abstract: METHODS
  Narrative overview of the focus issue on cervical spondylotic myelopathy (CSM).
  
  
  OBJECTIVE
  To provide an introduction to this special focus issue of Spine journal that deals with CSM.
  
  
  BACKGROUND
  CSM is a progressive spine disease and the leading cause of spinal cord dysfunction worldwide. The shift in population demographics in many parts of the world has motivated the development of this focus issue. With the overall aging of the population, we can predict that global health care systems will be confronted with an increase in patients presenting with degenerative spine changes and various stages of cervical myelopathy.
  
  
  METHODS
  The articles in this issue vary in their methods-there are systematic reviews, narrative reviews, a study protocol, and 2 primary research articles.
  
  
  RESULTS
  A summary of the findings of each article is provided as a table within this introduction.
  
  
  CONCLUSIONS
  By way of this issue, we have summarized current knowledge gaps and limitations in the evidence to provide direction for future research and investigation. These include the need for a unified nomenclature for referring to CSM, the need to specify the incidence of myelopathy and the prevalence of ossification of the posterior longitudinal ligament, and the need to explore both the safety and efficacy of neuroprotective and neuroreparative pharmacological strategies. Further work is also required to optimize the management of patients with minimal symptoms.
authors: *Toronto Western Hospital, University Health Network, Toronto, Ontario †Department of Surgery, Divisions of Neurosurgery and Orthopedic Surgery, Spinal Program, University of Toronto, Toronto, Ontario; and ‡Evidence-Based Practice Division, Spectrum Research, Inc., Tacoma, WA.
authors: Michael G
authors: MG
authors: Fehlings
authors: Lindsay A
authors: LA
authors: Tetreault
authors: Jefferson R
authors: JR
authors: Wilson
authors: Andrea C
authors: AC
authors: Skelly
mesh_terms: D035843:Biomedical Research; D002574:Cervical Vertebrae / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D010506:Periodicals as Topic; D012196:Review Literature as Topic; D013118:Spinal Cord Diseases / Q000503:physiopathology / Q000601:surgery*; D055009:Spondylosis / Q000503:physiopathology / Q000601:surgery*