Options of Management of the Patient with Mild Degenerative Cervical Myelopathy

Surgical management of patients with mild degenerative cervical myelopathy (DCM) is controversial. This article reviews 84 subjects with cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) who underwent surgical treatment. Nine had mild myelopathy: 6 CSM and 3 OPLL. Seven presented with pain or numbness of upper extremities. MRI revealed intramedullary hyperintensity in 55.6%. Five underwent anterior decompression and fusion, whereas 4 were operated posteriorly. Pain and intramedullary signal change on MRI are important. Management of patients with mild DCM should be determined individually, considering benefits and risks in long-term conservative treatment and surgery.