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SYMPOSIUM - CERVICAL SPONDYLOMYELOPATHY
Year : 2019  |  Volume : 2  |  Issue : 1  |  Page : 5-12

Natural history, prevalence, and pathophysiology of cervical spondylotic myelopathy


Department of Neurosurgery, AMRI Hospitals Salt Lake, Kolkata, West Bengal, India

Correspondence Address:
Dr. Gomatam Raghavan Vijay Kumar
1702 Tritiya, Upohar Luxury Complex, 2052 Chakgaria, Kolkata - 700 094, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/isj.isj_48_18

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This study is a narrative review performed to summarize the current knowledge about the epidemiology, natural history and pathogenesis of cervical spondylotic myelopathy (CSM). A comprehensive search was undertaken to look at all available articles between January 1, 1956 to May 1, 2018, on PubMed and the Cochrane Collaboration Library. The natural history of CSM is variable. The main determinants of the clinical course of CSM are the extent of neurological impairment, age, cervical instability, abnormalities of cord conduction, canal diameter, congenitally stenotic spinal canal and the extent of involvement and tract disruption on diffusion tensor imaging (DTI) imaging. There is little data on the true incidence and prevalence of CSM across the globe and none from India. The pathoanatomic basis of CSM is cord compression, either dynamic or static. The biological events that are thought to play a significant role in the development of CSM are ischemia, derangement of the blood-spinal cord barrier, chronic neuronal inflammation, and apoptosis. Emerging knowledge about the molecular biology holds promise for potential intervention, both for prevention and for cure, of this common and debilitating condition.


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