Chronic Spinal Cord Impairment: Stenosis and Syrinx Formation
Spinal cord injury (SCI) is usually thought of in the context of an acute injury event. But within an increasingly aging population, excessive narrowing of the spinal column (spinal stenosis) can lead to the emergence of a chronic spinal cord impairment analogous to a subacute spinal cord injury (cervical spondylotic myelopathy). Identifying spinal stenosis both by clinical and radiographic means provides an important foundation for informed care delivery. Understanding the dynamics of cysts within and surrounding the spinal cord may also considerably impact functioning neural elements and can cause secondary loss of neurologic function. Finally, the role of surgery in treating cervical spondylotic myelopathy — a chronic deterioration of spinal cord function — is discussed, along with data emerging from a large North American trial.