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Cervical Laminectomy and Fusion

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Degenerative Cervical Myelopathy and Radiculopathy

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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.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA

    Jacob Januszewski & Juan S. Uribe

  2. Department of Neurosurgery, The B.A.C.K Center, Melbourne, FL, USA

    Jacob Januszewski

Authors
  1. Jacob Januszewski
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  2. Juan S. Uribe
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Corresponding author

Correspondence to Jacob Januszewski .

Editor information

Editors and Affiliations

  1. Columbia University Medical Center, New York, NY, USA

    Michael G. Kaiser

  2. Atlanta Brain and Spine Care, Atlanta, GA, USA

    Regis W. Haid

  3. Duke University Health System, Durham, NC, USA

    Christopher I. Shaffrey

  4. Toronto Western Hospital, University of Toronto, Toronto, ON, Canada

    Michael G. Fehlings

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Januszewski, J., Uribe, J.S. (2019). Cervical Laminectomy and Fusion. In: Kaiser, M., Haid, R., Shaffrey, C., Fehlings, M. (eds) Degenerative Cervical Myelopathy and Radiculopathy . Springer, Cham. https://doi.org/10.1007/978-3-319-97952-6_27

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  • DOI: https://doi.org/10.1007/978-3-319-97952-6_27

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-97951-9

  • Online ISBN: 978-3-319-97952-6

  • eBook Packages: MedicineMedicine (R0)

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