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Cervical Laminectomy and Fusion

  • Jacob JanuszewskiEmail author
  • Juan S. Uribe
Chapter

Abstract

Degenerative cervical myelopathy (DCM) is a result of a combination of compressive, dynamic, and biomolecular factors on the spinal cord. Compression arises from narrowing of the ventral/dorsal cervical canal, disc degeneration, spondylosis, and ossification of the posterior longitudinal ligament (PLL) and ligamentum flavum leading to direct pressure on the spinal cord. Dynamic forces arise from abnormal cervical spinal alignment or motion as in cases with degenerative spondylolisthesis, subluxation, or kyphotic deformity. Physiological narrowing of canal diameter with neck extension as well as strain/stretch forces placed on the spinal cord with physiological neck movements also contributes to dynamic pathophysiological stresses. Finally, ischemic injury from chronic compression, subsequent release of inflammatory factors, glutamate-mediated excitotoxicity, and eventually neuronal apoptosis contribute to CSM on a molecular and cellular level. The goal of surgery, in turn, is first to decompress the neural structures and reduce the effect of static and biomolecular factors and, second, to stabilize the dynamic factors if such need exists.

Keywords

Degenerative cervical myelopathy DCM Cervical laminectomy Cervical spondylotic myelopathy CSM OPLL 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryBarrow Neurological InstitutePhoenixUSA
  2. 2.Department of NeurosurgeryThe B.A.C.K CenterMelbourneUSA

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