In the aging cervical spine Irreversible changes (=spondylosis, calcification) occur in the spine due to aging and/or the spine being under difficult conditions. These changes lead to stenosis in the spinal canal and nerve root canal and spinal cord and/or nerve compression. Spinal cord compression causes spinal cord damage, called myelopathy, which can become irreversible in the future. Neck stenosis = Cervical spondylosis is seen between cervical vertebrae 3 and 7 and most frequently in mobile areas such as 5/6 and 6/7, and can develop in a single space or in more than one space. The spinal cord canal is also congenitally narrow in some people. Clinical signs and symptoms may appear at an early age in these people.
What are the factors that cause compression of the spinal cord-nerve structures in the narrow spinal cord canal?
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Congenital narrow canal,
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New bone extensions called osteophytes,
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Cervical hernias,
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Ligamentum flavum hypertrophy, located on the back of the spinal cord and called the yellow ligament,
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Ossification of the posterior longitudinal ligament, located on the back of the spine,
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Deformed uncovertebral joints,
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Intervertebral joint (apophyseal joint) deformation or inflammation,
What are the factors that cause compression of the spinal cord-nerve structures in the narrow canal with neck movements?
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Normal and abnormal movement,
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Normal and abnormal loading,
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Folding of the ligamentum flavum when the head is tilted backwards,
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Sliding of the hypermobile segment backwards,
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Anterior and posterior Compression of the spinal cord between bone structures,
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Narrowing of the canal diameter when the head is tilted forward,
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Compression of the spinal cord from the front by stretching and decrease in the nutrition of the spinal cord
What is myelopathy?
Compression as a result of cervical spondylosis Pathological changes that develop in the damaged spinal cord and examined at the molecular level. In the spinal cord that is microscopically compressed, demyelination develops in the lateral columns, degeneration, edema, cell loss and necrosis develop in the posterior columns. Nerve cell damage in the gray matter can be very severe and myelomalasic and syringomyelic lesions may develop.
What are the widths of the cervical spine canals?
Myelopathy The cervical spinal canal in developing people is narrower than in normal people. Normal anteroposterior canal diameter is 17±5 mm between cervical 3 and 7, and pressure on nerve structures begins below 13 mm, and if it decreases below 10 mm, it is appropriate to consider myelopathy. In addition, while the spinal cord covers 1/2 of the canal in the upper cervical region, it covers 3/4 of it in the lower cervical region. For this reason, the luminal tolerance of the canal decreases as the lower segments go down, and spondylotic myelopathy is rare above the cervical level 3.
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