Understanding Cervical Myelopathy: A Comprehensive Guide

Edited by renowned experts Dr. Michael G. Fehlings and Dr. Junichi Mizuno, this issue of Neurosurgery Clinics delves into the complex and multifaceted topic of Cervical Myelopathy. This comprehensive guide aims to provide healthcare professionals and researchers with a detailed understanding of the clinical spectrum, pathobiology, and management strategies for degenerative cervical myelopathy.

Clinical Spectrum and Epidemiology

Degenerative cervical myelopathy is a common condition affecting millions worldwide. It is characterized by progressive damage to the spinal cord due to degenerative changes in the cervical spine. The clinical spectrum of this condition ranges from mild to severe, with varying degrees of motor and sensory impairments. Understanding the epidemiology of this condition is crucial for developing effective preventive and treatment strategies.

Pathobiology and Natural History

The pathobiology of degenerative cervical myelopathy involves a complex interplay of genetic, environmental, and biomechanical factors. The natural history of this condition is often marked by a slow progression of symptoms, which can significantly impact the quality of life for affected individuals. A thorough understanding of the underlying biological processes and the natural progression of the disease is essential for developing effective management strategies.

Imaging Evaluation and Sagittal Alignment

Imaging evaluation plays a critical role in diagnosing and managing degenerative cervical myelopathy. Advanced imaging techniques such as MRI and CT scans provide valuable insights into the extent of spinal cord compression and the degree of degenerative changes. Maintaining optimal sagittal alignment of the cervical spine is crucial for preventing further spinal cord damage and improving treatment outcomes.

Management Options and Complications

The management of degenerative cervical myelopathy often involves a multidisciplinary approach, including surgical and non-surgical options. Anterior cervical discectomy and fusion (ACDF), laminectomy with or without fusion, and laminoplasty are common surgical procedures used to manage this condition. However, these procedures carry potential risks and complications, such as neurological deficits and postoperative pain. A thorough understanding of the various management options and their associated risks is essential for healthcare professionals.

Future Directions and New Technologies

Advancements in medical technology and research are continually improving our understanding and management of degenerative cervical myelopathy. Emerging technologies such as stem cell therapy, gene therapy, and robotic-assisted surgery hold promise for improving treatment outcomes and reducing complications. Staying updated on the latest research and technological advancements is crucial for healthcare professionals working in this field.