Degenerative Cervical Myelopathy: A Brief Review of Past Perspectives, Present Developments, and Future Directions

Abstract

Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord injury in developed countries; its prevalence is increasing due to the ageing of the population. DCM causes neurological dysfunction and is a significant cause of disability in the elderly. It has important negative impacts on the quality of life of those affected, as well as on their caregivers. DCM is triggered by a variety of degenerative changes in the neck, which affect one or more anatomical structures, including intervertebral discs, vertebrae, and spinal canal ligaments. These changes can also lead to structural abnormalities, leading to alterations in alignment, mobility, and stability. The principle unifying problem in this disease, regardless of the types of changes present, is injury to the spinal cord due to compression by static and/or dynamic forces. This review is partitioned into three segments that focus on key elements of the past, the present, and the future in the field, which serve to introduce the focus issue on “Degenerative Cervical Myelopathy and the Aging Spine”. Emerging from this review is that tremendous progress has been made in the field, particularly in recent years, and that there are exciting possibilities for further advancements of patient care.

Degenerative Cervical Myelopathy: Review of Surgical Outcome Predictors and Need for Multimodal Approach

“…Degenerative Cervical Myelopathy (DCM) is a debilitating, progressive, degenerative spine condition, characterized by a neurological dysfunction due to static and dynamic injury of the spinal cord in the cervical spine (1,2). DCM affects quality of life to an extent greater than other chronic debilitating diseases, including hypertension and diabetes, and presents with an incidence of hospitalizations estimated at 4.04/100,000 person-years (3,4).…”

Does Spondylolisthesis Affect Severity and Outcome of Degenerative Cervical Myelopathy? A Systematic Review and Meta-analysis

“…2,4 Furthermore, studies reporting on natural history of DCS (risk of progression, instability, and space available for the cord) are 1 University of Geneva, Switzerland limited. 4 On the other hand, numerous articles discussed specific pathological criteria (for instance, ossification of the posterior longitudinal ligament, age, magnetic resonance imaging [MRI] signal change) 10,11 within the domain of degenerative cervical myelopathy (DCM) and their impact on baseline severity, surgical outcome, and management strategies. Given that DCS is a consequence of the degeneration cascade (including disc degeneration and hypertrophic arthropathy of the facet joints and ligaments), which is also true for other subsets of DCM, and typically manifests in the ageing spine, it is tempting to postulate that presence of DCS can directly influence the severity of DCM and outcome (Figure 1).…”

Degenerative Cervical Myelopathy and the Aging Spine: Introduction to the Special Issue

“…Degenerative Cervical Myelopathy (DCM) is becoming a growing public healthcare burden, attributable principally to an aging population. It represents a group of degenerative changes of the cervical spine that result in static and dynamic compression of the spinal cord, leading to subsequent chronic inflammatory and mechanical damage to neural tissue [ 1 , 2 , 3 ]. DCM represents the most common cause of spinal cord impairment in the developed world, leading not only to a decrease in the quality of life of those affected but also is increasingly recognized as a public healthcare and social burden [ 3 , 4 ].…”

“…DCM represents the most common cause of spinal cord impairment in the developed world, leading not only to a decrease in the quality of life of those affected but also is increasingly recognized as a public healthcare and social burden [ 3 , 4 ]. Over the past few years, research on this topic has allowed for a better understanding of its pathological features, natural history, diagnosis, severity, associated conditions, treatment thresholds, and outcomes, collectively helping to provide a better understanding of the condition [ 1 , 5 ]. However, this research effort has also clearly demonstrated the ongoing knowledge gaps that exist and require further investigation [ 2 ].…”

“…Twelve articles were published, comprising 1 narrative review and 11 original articles. The narrative review focused on the past perspectives, present developments, and future directions of DCM and is intended to provide an overview of the current status of DCM [ 1 ]. The editors of the issue contributed to this introductory review and decided to limit each of the past, present, and future sections to three themes in an effort to stay focused on the most important topics.…”