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Management of Mild Degenerative Cervical Myelopathy: Current Evidence and Emerging Directions
Niccolò Innocenti1, Edoardo Maria Barbieri2, Octavian Vatavu2
1Spine Neurosurgery Unit, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Giovanni Celoria 11, 20133, Milan, Italy.
Abstract:
Mild degenerative cervical myelopathy (DCM) is characterized by subtle neurologic deficits, including gait disturbance, hand dysfunction, and sensory changes. Management remains controversial, balancing early surgical intervention against structured nonoperative care. Current evidence suggests that surgery can halt disease progression and provide functional improvement, while carefully selected patients with stable, mild symptoms may be managed conservatively with close monitoring, physiotherapy, and education. Regular clinical and radiological follow-up is essential to detect deterioration. Timely transition to surgical decompression is recommended if neurologic decline occurs, emphasizing individualized, patient-centered decision-making.