Pathobiology of Spinal Cord Compression.

Degenerative cervical myelopathy results from chronic spinal cord compression, yet clinical severity often poorly correlates with imaging, reflecting complex pathobiology. Neuroinflammation, driven by microglia, macrophages, reactive astrocytes, and peripheral immune cells, along with metabolic failure due to ischemia, and hypoxia, contributes to progression while also shaping maladaptive and compensatory neuroplasticity. Growing evidence implicates gut dysbiosis in modulating systemic and spinal cord inflammation via the gut-spinal cord axis, influencing symptoms development and recovery. Biomarkers such as cytokines and microRNAs may aid early diagnosis and prognostication.