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Degenerative cervical myelopathy

  • Cervical Injuries and Treatment (HJ Kim, Section Editor)
  • Published:
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Abstract

Cervical myelopathy is the most common cause of acquired spinal cord compromise. The concept of degenerative cervical myelopathy (DCM), defined as symptomatic myelopathy associated with degenerative arthropathic changes in the spine axis, is being introduced. Given its progressive nature, treatment options have to be chosen in a timely manner. Surgical options include anterior discectomy and fusion (ACDF), anterior corpectomy and fusion (ACCF), arthroplasty (in highly select cases), posterior laminectomy with/without fusion, and laminoplasty. Indications for each should be carefully considered in individual patients. Riluzole, a sodium-glutamate antagonist, is a promising option to optimize neurologic outcomes post-surgery and is being examined in the CSM-Protect Randomized Controlled Trial. Preoperative risk assessment is mandatory for prognostication. Sagittal alignment is known to play an important role to optimize surgical outcome. Guidelines for optimal management of DCM are in process. In principle, all but the mildest cases of DCM should be offered surgery for optimal outcome.

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Authors and Affiliations

  1. Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, ON, Canada

    So Kato & Michael Fehlings

  2. Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada

    Michael Fehlings

  3. Division of Neurosurgery, Toronto Western Hospital, 399 Bathurst St. Suite 4WW-449, Toronto, ON, M5T2S8, Canada

    Michael Fehlings

Authors
  1. So Kato
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  2. Michael Fehlings
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Correspondence to Michael Fehlings.

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So Kato and Michael Fehlings declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Cervical Injuries and Treatment

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Kato, S., Fehlings, M. Degenerative cervical myelopathy. Curr Rev Musculoskelet Med 9, 263–271 (2016). https://doi.org/10.1007/s12178-016-9348-5

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  • DOI: https://doi.org/10.1007/s12178-016-9348-5

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