Cervical Myelopathy: Pathophysiology, Diagnosis, and Management

The natural history of cervical myelopathy involves both static and dynamic factors which trigger a cascade of reactions resulting in cord compression and ischemic dysfunction of the spinal cord. Conservative management is an option in those with mild Cervical Spondylotic Myelopathy (CSM), though close clinical and radiological follow-up is important. Operative management remains the standard of treatment for more symptomatic CSM, however, indications must be carefully considered with each individual patient. A randomized, double-blind, placebo-controlled multi-centre study, assessing whether Riluzole (a neuroprotective drugs) has any benefits as a treated for surgical decompression in those with CSM, is being carried out. Here we review the pathophysiological, diagnostic and treatment aspects of CSM.