Degenerative Cervical Myelopathy: Recognition and Management.

Area of Science:

• Neurology
• Neurosurgery
• Orthopedics

Background:

• Degenerative cervical myelopathy (DCM) is a progressive condition causing spinal cord dysfunction from cervical spine compression.
• It predominantly affects males around 64 years old, with unclear incidence due to varied terminology and asymptomatic radiographic findings.
• Key symptoms include neck pain, gait disturbance, sensory changes, weakness, and potentially bowel/bladder dysfunction in severe cases.

Purpose of the Study:

• To outline the presentation, diagnosis, and management of degenerative cervical myelopathy.
• To emphasize the role of primary care physicians in early recognition and management.

Main Methods:

• Diagnosis relies on correlating clinical examination findings with imaging studies.
• Magnetic resonance imaging (MRI) of the cervical spine is the primary diagnostic modality.
• CT scans, CT myelography, and plain radiography can be supplementary.

Main Results:

• Treatment decisions are guided by symptom severity and disease progression.
• Surgery is indicated for moderate to severe or rapidly progressing DCM.
• Conservative management with monitoring is an option for mild to moderate cases, though evidence is limited.

Conclusions:

• Early recognition of DCM by primary care physicians is crucial for timely intervention.
• Management involves coordinating treatment and addressing comorbidities.
• The evidence base for conservative treatments in DCM is currently limited and of low quality.