Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jan 18, 2016; 7(1): 20-29
Published online Jan 18, 2016. doi: 10.5312/wjo.v7.i1.20
Mechanical and cellular processes driving cervical myelopathy
Roisin T Dolan, Joseph S Butler, John M O’Byrne, Ashley R Poynton
Roisin T Dolan, Department of Trauma and Orthopaedic Surgery, Waterford Regional Hospital, X91 ER8E Waterford, Ireland
Joseph S Butler, National Spinal Injuries Unit, Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, D07 AX57 Dublin, Ireland
John M O’Byrne, Department of Trauma and Orthopaedic Surgery, Royal College of Surgeons in Ireland, Cappagh National Orthopaedic Hospital, D11 K316 Dublin, Ireland
Ashley R Poynton, Department of Trauma and Orthopaedic Surgery, Mater Private Hospital, D07 WKW8 Dublin, Ireland
Author contributions: All authors had significant contributions to the conception and design of the review article; Dolan RT and Butler JS contributed to drafting the article; O’Byrne JM and Poynton AR were responsible for revising it critically for important intellectual content.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. Roisin T Dolan, MA, MD, MRCSI, Department of Trauma and Orthopaedic Surgery, Waterford Regional Hospital, Dunmore Rd., X91 ER8E Waterford, Ireland.
Telephone: +353-51-858000 Fax: +353-51-858001
Received: December 26, 2014
Peer-review started: December 29, 2014
First decision: February 10, 2015
Revised: October 12, 2015
Accepted: November 3, 2015
Article in press: November 4, 2015
Published online: January 18, 2016
Core Tip

Core tip: The pathophysiology of cervical myelopathy involves a combination of mechanical static and dynamic factors, triggering a cascade of biomolecular changes to include ischemia, excitotoxicity, neuroinflammation and apoptosis. Development of targeted neuro-protective treatment strategies, specifically modulating these molecular pathways, may optimize neurological recovery following surgical decompression. The aim of this review is to provide an overview of the pathophysiological processes at play in the development of cervical myelopathy.