Funktionelle, bildgebende und molekulare Evaluation der zervikalen degenerativen Myelopathie

Zusammenfassung

Die degenerative zervikale Myelopathie (DZM) ist eine häufige Ursache für altersbedingte Rückenmarksschädigungen. Schätzungen zufolge weisen 70–90 % der über 50- bis 60-jährigen Menschen degenerative Veränderungen der Halswirbelsäule auf. Die Alterung der Bevölkerung lässt eine Zunahme der DZM-Inzidenz erwarten, welche eine optimierte Diagnostik und Behandlung dringend erforderlich macht. Während die aktuellen AO-Spine-Leitlinien 2017 auf moderaten Evidenzniveaus basieren, zeigen neue Forschungsergebnisse wichtige Fortschritte in der bildgebenden und funktionellen Diagnostik. Techniken wie die transkranielle Magnetstimulation (TMS) und Magnetresonanzspektroskopie (MRS) erlauben tiefere Einblicke in funktionelle und metabolische Veränderungen im Gehirn, die den Krankheitsverlauf widerspiegeln. Diese Fortschritte könnten zu präziseren und auf den individuellen Verlauf abgestimmten Therapien führen. Das Behandlungskonzept und die Lebensqualität von DZM-Patienten könnte so gezielt verbessert werden.

Abstract

Degenerative cervical myelopathy (DCM) is a common cause of age-related spinal cord damage. It is estimated that 70–90% of people over the age of 50 to 60 show degenerative changes in the cervical spine. The aging of the population suggests an increase in the incidence of DCM, making optimized diagnosis and treatment urgently necessary. While the current AO Spine Guidelines 2017 are based on moderate levels of evidence, new research results show important advances in imaging and functional diagnostics. Techniques such as transcranial magnetic stimulation (TMS) and magnetic resonance spectroscopy (MRS) provide deeper insights into functional and metabolic changes in the brain that reflect the course of the disease. These advances could lead to more precise and individualized therapies. The treatment concept and quality of life of DZM patients could thus be improved in a targeted manner.

Schlüsselwörter

degenerative zervikale Myelopathie - Blut-Rückenmark-Schranken-Störung - kortikale Reservekapazität - sekundäre Schädigungsmechanismen - Myelopathie

Keywords

degenerative cervical myelopathy - blood-spinal cord barrier disorder - cortical reserve capacity - secondary damage mechanisms - myelopathy

Publication History

Article published online:
07 April 2025

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