Degenerative cervical myelopathy: Evolving concepts in diagnosis and treatment

Degenerative cervical myelopathy (DCM) is a progressive, age-related condition caused by degenerative changes in the cervical spine that result in spinal cord compression and neurologic dysfunction. Though it is the leading cause of spinal cord impairment among adults, it is underrecognized in clinical practice due to its variable and often subtle presentation, resulting in delays in intervention and preventable morbidity and mortality. Timely diagnosis and intervention are critical, as shorter symptom duration is associated with superior outcomes. Heightened clinical vigilance and updated practice patterns are therefore essential among health care providers who are likely to encounter these patients in primary care, emergency medicine, urgent care, orthopedic, rheumatology, neurology, and neurosurgery settings. Emerging evidence favors early surgical intervention in progressive or moderate to severe disease among all patients, including older adults, to optimize outcomes and limit irreversible deficits.