Back to Basics: Degenerative Cervical Myelopathy

Spine & Nerve

In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves discuss Degenerative Cervical Myelopathy (DCM). DCM, previously called cervical spondylotic myelopathy, is defined as neurologic injury to the cervical spinal cord due to various age-related degenerative conditions of the cervical spine resulting in injury to the spinal cord secondary to static compression, and/or dynamic injury due to instability. DCM results in symptoms including loss of hand function / dexterity, imbalance/falls, weakness, numbness, pain, bladder / bowel dysfunction. DCM is a common disease process- it is the most common cause of spinal cord injury in the developed world. Natural history studies of DCM show that for patients with significant cervical stenosis, the risk of development of DCM is 8% at 1 year, and up to 23% at 3-4 year follow up. Dr. Karadimas and his colleagues found that between 20-60% of patients with initially mild DCM will have significant clinical deterioration over time; as measured by functional outcome measures including Timed 10 meter walk, and ADL’s score. This understanding of the typical natural history of DCM highlights the importance of close monitoring of patients with significant cervical stenosis, and prompt surgical referral once DCM is diagnosed. Listen as the doctors discuss this important topic including the definition, epidemiology, clinical presentation, diagnosis, and management. This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve. References: 1. Lebl, Darren R. MD; Bono, Christopher M. MD Update on the Diagnosis and Management of Cervical Spondylotic Myelopathy, Journal of the American Academy of Orthopaedic Surgeons: November 2015 - Volume 23 - Issue 11 - p 648-660. 2. Nouri A, Cheng JS, Davies B, Kotter M, Schaller K, Tessitore E. Degenerative Cervical Myelopathy: A Brief Review of Past Perspectives, Present Developments, and Future Directions. J Clin Med. 2020;9(2):535.