The Natural History of Degenerative Cervical Myelopathy

Although degenerative cervical myelopathy (DCM) is the leading cause of spinal cord dysfunction among adults worldwide, little is known about its natural history. There is mounting evidence of the effectiveness of surgery for DCM in halting progression of symptoms and, in fact, in improving neurologic outcomes, functional status, and quality of life. However, surgical decision making relies on a weighing of the risks and benefits of alternative strategies. The authors reviewed the available literature pertaining to the natural course of DCM and the predictors of outcome of nonoperative approaches.