Blood-spinal cord barrier disruption in degenerative cervical myelopathy
Abstract Degenerative cervical myelopathy (DCM) is the most prevalent cause of spinal cord dysfunction in the aging population. Significant neurological deficits may result from a delayed diagnosis as well as inadequate neurological recovery following surgical decompression. Here, we review the path...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Fluids and Barriers of the CNS |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12987-023-00463-y |
| _version_ | 1797557056610238464 |
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| author | Hyun Woo Kim Hu Yong Graham Ka Hon Shea |
| author_facet | Hyun Woo Kim Hu Yong Graham Ka Hon Shea |
| author_sort | Hyun Woo Kim |
| collection | DOAJ |
| description | Abstract Degenerative cervical myelopathy (DCM) is the most prevalent cause of spinal cord dysfunction in the aging population. Significant neurological deficits may result from a delayed diagnosis as well as inadequate neurological recovery following surgical decompression. Here, we review the pathophysiology of DCM with an emphasis on how blood-spinal cord barrier (BSCB) disruption is a critical yet neglected pathological feature affecting prognosis. In patients suffering from DCM, compromise of the BSCB is evidenced by elevated cerebrospinal fluid (CSF) to serum protein ratios and abnormal contrast-enhancement upon magnetic resonance imaging (MRI). In animal model correlates, there is histological evidence of increased extravasation of tissue dyes and serum contents, and pathological changes to the neurovascular unit. BSCB dysfunction is the likely culprit for ischemia–reperfusion injury following surgical decompression, which can result in devastating neurological sequelae. As there are currently no therapeutic approaches specifically targeting BSCB reconstitution, we conclude the review by discussing potential interventions harnessed for this purpose. |
| first_indexed | 2024-03-10T17:11:47Z |
| format | Article |
| id | doaj.art-2527bf7e2eed4c71ac12080337b5d2e5 |
| institution | Directory Open Access Journal |
| issn | 2045-8118 |
| language | English |
| last_indexed | 2024-03-10T17:11:47Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Fluids and Barriers of the CNS |
| spelling | doaj.art-2527bf7e2eed4c71ac12080337b5d2e52023-11-20T10:36:58ZengBMCFluids and Barriers of the CNS2045-81182023-09-0120111810.1186/s12987-023-00463-yBlood-spinal cord barrier disruption in degenerative cervical myelopathyHyun Woo Kim0Hu Yong1Graham Ka Hon Shea2Department of Orthopaedics and Traumatology, LKS Faulty of Medicine, The University of Hong KongDepartment of Orthopaedics and Traumatology, LKS Faulty of Medicine, The University of Hong KongDepartment of Orthopaedics and Traumatology, LKS Faulty of Medicine, The University of Hong KongAbstract Degenerative cervical myelopathy (DCM) is the most prevalent cause of spinal cord dysfunction in the aging population. Significant neurological deficits may result from a delayed diagnosis as well as inadequate neurological recovery following surgical decompression. Here, we review the pathophysiology of DCM with an emphasis on how blood-spinal cord barrier (BSCB) disruption is a critical yet neglected pathological feature affecting prognosis. In patients suffering from DCM, compromise of the BSCB is evidenced by elevated cerebrospinal fluid (CSF) to serum protein ratios and abnormal contrast-enhancement upon magnetic resonance imaging (MRI). In animal model correlates, there is histological evidence of increased extravasation of tissue dyes and serum contents, and pathological changes to the neurovascular unit. BSCB dysfunction is the likely culprit for ischemia–reperfusion injury following surgical decompression, which can result in devastating neurological sequelae. As there are currently no therapeutic approaches specifically targeting BSCB reconstitution, we conclude the review by discussing potential interventions harnessed for this purpose.https://doi.org/10.1186/s12987-023-00463-yDegenerative cervical myelopathyBlood-spinal cord barrierCervical decompressionIschemiaInflammationCell therapy |
| spellingShingle | Hyun Woo Kim Hu Yong Graham Ka Hon Shea Blood-spinal cord barrier disruption in degenerative cervical myelopathy Fluids and Barriers of the CNS Degenerative cervical myelopathy Blood-spinal cord barrier Cervical decompression Ischemia Inflammation Cell therapy |
| title | Blood-spinal cord barrier disruption in degenerative cervical myelopathy |
| title_full | Blood-spinal cord barrier disruption in degenerative cervical myelopathy |
| title_fullStr | Blood-spinal cord barrier disruption in degenerative cervical myelopathy |
| title_full_unstemmed | Blood-spinal cord barrier disruption in degenerative cervical myelopathy |
| title_short | Blood-spinal cord barrier disruption in degenerative cervical myelopathy |
| title_sort | blood spinal cord barrier disruption in degenerative cervical myelopathy |
| topic | Degenerative cervical myelopathy Blood-spinal cord barrier Cervical decompression Ischemia Inflammation Cell therapy |
| url | https://doi.org/10.1186/s12987-023-00463-y |
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