Cervical Spondylotic Myelopathy: The Clinical Phenomenon and the Current Pathobiology of an Increasingly Prevalent and Devastating Disorder

被引:319
作者
Kalsi-Ryan, Sukhvinder [1 ,2 ,3 ]
Karadimas, Spyridon K. [2 ,4 ]
Fehlings, Michael G. [5 ,6 ]
机构
[1] Univ Toronto, Dept Phys Therapy, Toronto, ON, Canada
[2] Toronto Western Hosp, Krembil Neurosci Ctr, Toronto, ON M5T 2S8, Canada
[3] Toronto Rehabil Inst, Toronto, ON, Canada
[4] Univ Toronto, Inst Med Sci, Toronto, ON, Canada
[5] Univ Toronto, Dept Surg, Toronto, ON, Canada
[6] Univ Toronto, Neurosci Program, Toronto, ON, Canada
关键词
cervical spondylotic myelopathy; spinal cord injury; cervical spine; epidemiology; pathobiology; CHRONIC MECHANICAL COMPRESSION; INCREASED SIGNAL INTENSITY; SPINAL-CORD DYSFUNCTION; ANTERIOR HORN NEURONS; PROGNOSTIC-FACTORS; NATURAL-HISTORY; INCREASED EXPRESSION; SURGICAL-TREATMENT; ANIMAL-MODEL; MR-IMAGES;
D O I
10.1177/1073858412467377
中图分类号
R74 [神经病学与精神病学];
学科分类号
100204 [神经病学];
摘要
Cervical spondylotic myelopathy (CSM) is a common disorder involving chronic progressive compression of the cervical spinal cord due to degenerative disc disease, spondylosis, or other degenerative pathology. CSM is the most common form of spinal cord impairment and causes functional decline leading to reduced independence and quality of life. Despite a sound understanding of the disease process, clinical presentation and management, a universal definition of CSM and a standardized index of severity are not currently used universally. Work is required to develop a definition and establish clinical predictors of progression to improve management of CSM. Despite advances in decompressive and reconstructive surgery, patients are often left with residual disability. Gaps in knowledge of the pathobiology of CSM have limited therapeutic advances to complement surgery. Although the histopathologic and pathophysiologic similarities between CSM and traumatic spinal cord injury have long been acknowledged, the unique pathomechanisms of CSM remain unexplored. Increased efforts to elucidate CSM pathobiology could lead to the discovery of novel therapeutic targets for human CSM and other spinal cord diseases. Here, the natural history of CSM, epidemiology, clinical presentation, and current methods of clinical management are reported, along with the current state of basic scientific research in the field.
引用
收藏
页码:409 / 421
页数:13
相关论文
共 89 条
[1]
Prognostic Factors That Affect the Surgical Outcome of the Laminoplasty in Cervical Spondylotic Myelopathy [J].
Ahn, Jae-Sung ;
Lee, June-Kyu ;
Kim, Bo-Kun .
CLINICS IN ORTHOPEDIC SURGERY, 2010, 2 (02) :98-104
[2]
Laminectomy and fusion for the treatment of cervical degenerative myelopathy [J].
Anderson, Paul A. ;
Matz, Paul G. ;
Groff, Michael W. ;
Heary, Robert F. ;
Holly, Langston T. ;
Kaiser, Michael G. ;
Mummaneni, Praveen V. ;
Ryken, Timothy C. ;
Choudhri, Tanvir F. ;
Vresilovic, Edward J. ;
Resnick, Daniel K. .
JOURNAL OF NEUROSURGERY-SPINE, 2009, 11 (02) :150-156
[3]
Postoperative Magnetic Resonance Imaging Can Predict Neurological Recovery After Surgery for Cervical Spondylotic Myelopathy: A Prospective Study With Blinded Assessments [J].
Arvin, Babak ;
Kalsi-Ryan, Sukhvinder ;
Karpova, Alina ;
Mercier, David ;
Furlan, Julio C. ;
Massicotte, Eric M. ;
Fehlings, Michael G. .
NEUROSURGERY, 2011, 69 (02) :362-368
[4]
Comparison of prognostic value of different MRI classifications of signal intensity change in cervical spondylotic myelopathy [J].
Avadhani, Ashwin ;
Rajasekaran, S. ;
Shetty, Ajoy P. .
SPINE JOURNAL, 2010, 10 (06) :475-485
[5]
THE EFFECT OF CERVICAL MOBILITY ON THE NATURAL-HISTORY OF CERVICAL SPONDYLOTIC MYELOPATHY [J].
BARNES, MP ;
SAUNDERS, M .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1984, 47 (01) :17-20
[6]
Cervical spondylotic myelopathy: A brief review of its pathophysiologyf clinical course, and diagnosis [J].
Baron, Eli M. ;
Young, William F. .
NEUROSURGERY, 2007, 60 (01) :35-42
[7]
Tight squeeze, slow burn: inflammation and the aetiology of cervical myelopathy [J].
Beattie, Michael S. ;
Manley, Geoffrey T. .
BRAIN, 2011, 134 :1259-1261
[8]
ABNORMAL MAGNETIC-RESONANCE SCANS OF THE CERVICAL-SPINE IN ASYMPTOMATIC SUBJECTS - A PROSPECTIVE INVESTIGATION [J].
BODEN, SD ;
MCCOWIN, PR ;
DAVIS, DO ;
DINA, TS ;
MARK, AS ;
WIESEL, S .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1990, 72A (08) :1178-1184
[9]
THE PATHO-PHYSIOLOGY OF CERVICAL SPONDYLOSIS AND MYELOPATHY [J].
BOHLMAN, HH ;
EMERY, SE .
SPINE, 1988, 13 (07) :843-846
[10]
Features of skin-coincubated macrophages that promote recovery from spinal cord injury [J].
Bomstein, Y ;
Marder, JB ;
Vitner, K ;
Smirnov, I ;
Lisaey, G ;
Butovsky, O ;
Fulga, V ;
Yoles, E .
JOURNAL OF NEUROIMMUNOLOGY, 2003, 142 (1-2) :10-16