Table of Contents
ISRN Neurology
Volume 2011, Article ID 463729, 5 pages
Review Article

Cervical Spondylotic Myelopathy: Pathophysiology, Diagnosis, and Surgical Techniques

1Department of Neurosurgery, University of Illinois College of Medicine at Peoria, Peoria, IL 6156-1649, USA
2League of Neurosurgery, The Neurologival Institute of Curitiba, 81210-310 Curitiba, PR, Brazil
3Instituto de Neurologia de Curitiba, 81210-310 Curitiba, PR, Brazil
4Department of Neurosurgery, University of Illinois College of Medicine at Peoria, Peoria, IL, USA

Received 6 July 2011; Accepted 25 July 2011

Academic Editors: P. Annunziata and W. Lüdemann

Copyright © 2011 Tobias A. Mattei et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Cervical spondylotic myelopathy is a degenerative spinal disease which may lead to significant clinical morbidity. The onset of symptoms is usually insidious, with long periods of fixed disability and episodic worsening events. Regarding the pathophysiology of CSM, the repeated injuries to the spinal cord are caused by both static and dynamic mechanical factors. The combination of these factors affects the spinal cord basically through both direct trauma and ischemia. Regarding the diagnosis, both static and dynamics X-rays, as well as magnetic resonance imaging are important for preoperative evaluation as well as individualizing surgical planning. The choice of the most appropriate technique is affected by patient's clinical condition radiologic findings, as well as surgeon's experience. In opposition to the old belief that patients presenting mild myelopathy should be treated conservatively, there has progressively been amount of evidence indicating that the clinical course of this disease is progressive deterioration and that early surgical intervention improves long-term functional recovery and neurological prognosis.