Abstract
Progressive arthritic changes can narrow the cervical spinal canal, lead to spinal cord compression, and progressively impair spinal cord function. Degenerative cervical myelopathy (DCM) is due to chronic, nontraumatic compression of the cervical spinal cord. DCM defines neurological impairment secondary to extrinsic compression of the spinal cord by degeneration in the intervertebral disks, supporting ligaments and vertebral bodies. DCM is the leading cause of spinal cord injury worldwide and causes significant disability and reduced quality of life. Prevalence in a 2017 Canadian study was estimated at 1120 per million. For patients with DCM, there is an estimated 3%–62% rate of neurological deterioration over 2.5–8.2 years. The clinical manifestations of this disease vary in severity. Patients with mild DCM may experience intermittent hand paresthesias that does not impact quality of life, whereas those with severe myelopathy may not be able to safely ambulate without assistance. The course of the disease without operative intervention is referred to as the natural history.
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