Purpose of review: The article discusses the current diagnostic and therapeutic approach to myelopathies occurring as a consequence of structural cervical and thoracic spine disease.
Recent findings: The exact pathophysiologic basis of cervical spondylotic myelopathy remains somewhat elusive. Diffusion-tensor imaging has emerged as a useful imaging modality that correlates more closely with clinical severity than standard MRI. Baseline disease severity, symptom duration, age, presence of impaired gait, and smoking status are significant factors related to surgical outcomes.
Summary: Advances in neuroimaging and the development of evidence-based algorithmic approaches to surgical intervention will likely further improve the outcomes of patients with spinal cord dysfunction from structural cervical and thoracic disease.