321 - Evaluation and Treatment of Degenerative Cervical Myelopathy

Abstract

Degenerative cervical myelopathy (DCM) is the leading cause of spinal cord dysfunction among adults. This clinicopathologic entity is characterized by progressive neurological disability owing to spinal cord compression secondary to age-related degeneration or ligamentous aberrations of the cervical spinal column. The evaluation of a patient with suspected DCM requires a careful history and physical examination along with magnetic resonance imaging (MRI), which is obtained to assess the anatomic source and severity of spinal cord compression as well as rule out other potential causes of myelopathy. Surgery is the mainstay of treatment for DCM. Surgical decompression halts progression of clinical deficits and improves long-term neurological function, disability, and health-related quality of life. The natural history of DCM is highly variable, but generally entails progressive decline and, at best, no worsening in neurological function. Expeditious diagnosis and treatment may prevent the development of otherwise severe, irreversible deficits.