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Degenerative Cervical Myelopathy: Pathophysiology and Current Treatment Strategies

Asian Spine Journal 2020년 14권 5호 p.710 ~ 720
Choi Sung-Hoon, 강창남,
소속 상세정보
 ( Choi Sung-Hoon ) - Hanyang University College of Medicine Department of Orthopedic Surgery
강창남 ( Kang Chang-Nam ) - Hanyang University College of Medicine Department of Orthopedic Surgery

Abstract


Chronic compression or ischemia of the spinal cord in the cervical spine causes a clinical syndrome known as cervical myelopathy. Recently, a new term “degenerative cervical myelopathy (DCM)” was introduced. DCM encompasses spondylosis, intervertebral disk herniation, facet arthrosis, ligamentous hypertrophy, calcification, and ossification. The pathophysiology of DCM includes structural and functional abnormalities of the spinal cord caused by static and dynamic factors. In nonoperative patients, cervical myelopathy has a poor prognosis. Surgical treatments, such as anterior or posterior decompression accompanying arthrodesis, arthroplasty, or laminoplasty, should be considered for patients with chronic progressive cervical myelopathy. Surgical decompression can prevent the progression of myelopathy and improve the neurologic status, functional outcomes, and quality of life, irrespective of differences in medical systems and sociocultural determinants of health. The anterior surgical approach to the cervical spine has the advantage of removing or floating the intervertebral disk, osteophytes, and ossification of the posterior longitudinal ligament that compress the spinal cord directly. The posterior surgical approach to the cervical spine is mainly used for multisegment spinal cord compression in patients with cervical lordosis. In this review article, we addressed the pathophysiology, clinical manifestations, differential diagnosis, and treatment options for DCM.

키워드

Spinal cord; Myelopathy; Cervical spine; Decompression; Surgery

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