Degenerative Cervical Myelopathy Evaluation and Management

DCM is typically caused by cervical spondylosis resulting in narrowing of the spinal canal and spinal cord compression. Its symptoms are characterized by upper extremity weakness or paresthesia, clumsiness of hands, and gait abnormalities. The natural history of DCM is that of a stepwise deterioration. Nonoperative treatment can be attempted in asymptomatic patients and potentially those with mild symptoms but clinical follow-up is recommended to monitor for deterioration. Otherwise, surgical intervention is recommended either through an anterior, posterior, or combined approach while considering patient and pathologic condition characteristics to minimize com-plications. Outcome measures have proven significant improvement is gained with surgical intervention regardless of approach. Better out-comes are seen in younger, nonsmoking, less co-morbid patients, with shorter duration of symptoms, and those presenting without gait dysfunction.

Automated summary

DCM is caused by cervical spondylosis, resulting in spinal canal narrowing and spinal cord compression. Its symptoms include upper extremity weakness or paresthesia, hand clumsiness, and gait abnormalities. Nonoperative treatment can be attempted for asymptomatic or mild symptomatic patients, while surgical intervention is recommended for significant improvement, especially in younger, nonsmoking, less comorbid patients with shorter symptom duration and no gait dysfunction.