Chapter 13 - Defining the position of rehabilitation in the management of degenerative cervical myelopathy

Abstract

The role of rehabilitation and rehab professionals in the management of degenerative cervical myelopathy (DCM) is relatively new and under-established. While the DCM population presents with a number of rehabilitation issues, little resource has been put forth to provide DCM patients with specific multidisciplinary intervention for clinical management. In this chapter, we review the current use of rehabilitation in the management of DCM and the current literature that defines the field of outcomes assessment in DCM. We use these findings to help define the role of rehab as it relates to close monitoring of a progressive disease. We then take this evidence one step further and consider the most meaningful way to apply this new knowledge to how current management of DCM can be enhanced by building stronger multidisciplinary support, earlier detection of disease and opportunities to enhance neuroplasticity for optimization of this population. We also aim to expose the nuances of DCM and how this disease has a slightly different presentation from traumatic spinal cord injury (SCI). Hence, modified rehab approaches need to be considered; applying existing rehab models from traumatic SCI is not sufficient.