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Chapter 16 - Degenerative Cervical Myelopathy

from Section 2 - Clinical Neurosurgical Diseases

Published online by Cambridge University Press:  04 January 2024

By
T.J. Florence ,
Joel S. Beckett  and
Langston T. Holly
Edited by
Farhana Akter ,
Nigel Emptage ,
Florian Engert  and
Mitchel S. Berger
Farhana Akter
Affiliation:
Harvard University, Massachusetts
Nigel Emptage
Affiliation:
University of Oxford
Florian Engert
Affiliation:
Harvard University, Massachusetts
Mitchel S. Berger
Affiliation:
University of California, San Francisco
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Summary

Degenerative cervical myelopathy(DCM) is the most debilitating form of degenerative disc disease, and is the most common acquired cause of spinal cord dysfunction in adults. DCM is caused by progressive abnormalities of the vertebral column that result in spinal cord damage due to both primary mechanical and secondary biological injury. DCM pathohistology demonstrates a consistent pattern of deleterious changes including severe Wallerian degeneration cephalad and caudal to the level of compression, apoptotic oligodendrocyte cell loss, and anterior horn dropout. Spinal cord ischemia and hypoxia play a major role in DCM pathogenesis. Novel spinal cord imaging studies such as MR spectroscopy and diffusion tensor imaging have provided novel insights into the neurobiology of this disorder. The central nervous system effects of DCM not only involve the spinal cord, but also include upstream functional and structural alterations that can influence disease progression and response to surgical intervention.

Type
Chapter
Information
Neuroscience for Neurosurgeons , pp. 239 - 247
Publisher: Cambridge University Press
Print publication year: 2024

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