MRI evidence of brain atrophy, white matter damage, and functional adaptive changes in patients with cervical spondylosis and prolonged spinal cord compression复制标题

颈椎病和脊髓长时间压迫患者脑萎缩、脑白质损伤和功能适应性改变的MRI证据

Cervical spondylosis (CS) is a chronic degenerative disease present in the majority of people after the fifth decade of life. Frequently found in asymptomatic adults, it may progress to spinal cord compression and cervical spondylotic myelopathy (CSM). The evolution from CS to CSM is highly variable and difficult to predict, with patients experiencing a rather benign form of the disease while others experiencing substantial deterioration over time. Generally, the treatment for mild and moderate disease is conservative, with surgical intervention advised for patients with severe intractable pain, progressive disease, or associated neurological deficits. Yet, in some patients with mild or moderate disease, the absence of pain and the imprecision of the clinical manifestations could mask the development of a severe CSM.Despite the potential irreversible neurological deficits of CS, its pathophysiology is still poorly understood. The majority of the studies have been focused on the spinal cord overlooking its connection with the cortex, with few studies analyzing the effects of CSM in the brain, suggesting that CSM can lead to neuronal damage distal to the spinal lesion and functional reorganization of the sensorimotor cortex that could be relevant for postsurgical recovery.

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