Degenerative cervical myelopathy: Where have we been? Where are we now? Where are we going?

Hejrati, Nader; Pedro, Karlo M.; Alvi, Mohammed A; Quddusi, Ayesha; Fehlings, Michael G.

doi:10.1007/s00701-023-05558-x

Cited by 10 publications

(5 citation statements)

References 128 publications

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“…Recently, Degenerative Cervical Myelopathy (DCM) has emerged as an umbrella term for many age-related and genetically associated pathologies. 33,34 DCM includes cervical spondylotic myelopathy, degenerative disc disease, OPLL, and other conditions. 33 The similarity between the three aforementioned conditions is that they all produce Cervical Myelopathy: Diagnosis and Surgical Strategies SurgiColl chronic spinal cord compression; common symptoms include decreased hand dexterity, gait imbalance, and genitourinary or sensorimotor disturbances.…”

Section: Recent Controversiesmentioning

confidence: 99%

“…33,34 DCM includes cervical spondylotic myelopathy, degenerative disc disease, OPLL, and other conditions. 33 The similarity between the three aforementioned conditions is that they all produce Cervical Myelopathy: Diagnosis and Surgical Strategies SurgiColl chronic spinal cord compression; common symptoms include decreased hand dexterity, gait imbalance, and genitourinary or sensorimotor disturbances. 33 The similarities between DCM conditions result in an ongoing debate regarding clinical decision-making, ideal intervention timing, and best surgical approach.…”

Section: Recent Controversiesmentioning

confidence: 99%

“…33 The similarity between the three aforementioned conditions is that they all produce Cervical Myelopathy: Diagnosis and Surgical Strategies SurgiColl chronic spinal cord compression; common symptoms include decreased hand dexterity, gait imbalance, and genitourinary or sensorimotor disturbances. 33 The similarities between DCM conditions result in an ongoing debate regarding clinical decision-making, ideal intervention timing, and best surgical approach. 33 Out of the need for advancements in the management of DCM emerged an international multistakeholder consensus group called Research Objectives and Common Data Elements RECODE-DCM.…”

Section: Recent Controversiesmentioning

confidence: 99%

“…33 The similarities between DCM conditions result in an ongoing debate regarding clinical decision-making, ideal intervention timing, and best surgical approach. 33 Out of the need for advancements in the management of DCM emerged an international multistakeholder consensus group called Research Objectives and Common Data Elements RECODE-DCM. 34 Notably, RECODE-DCM has refined the definition of DCM.…”

Section: Recent Controversiesmentioning

confidence: 99%

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Cervical Myelopathy: Diagnosis and Surgical Strategies

Paschal,

Zelenty,

Sama

et al. 2023

SurgiColl

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Cervical myelopathy, a condition caused by compression of the spinal cord in the neck, is characterized by an insidious onset with slow clinical deterioration; however, it can have a rapid progression in a subset of patients, culminating in spinal cord damage/injury. In elderly patients, Cervical myelopathy is marked by multifaceted deterioration of the anatomic structures in the spinal column. Injuries can result in more acute presentations of Cervical myelopathy. Symptoms typically stem from mechanical pressure and ischemic changes exerted on the spinal cord. Common symptoms include neck pain/stiffness, spasticity/balance and gait dysfunction, loss of dexterity and fine motor movements, and upper and lower extremity dysesthesias. To diagnose accurately, a detailed history and physical examination are required. Radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) are often needed, with MRI being the gold standard. Many surgical approaches exist to address spinal cord compression. The surgical approach is influenced by several factors: the exact location of cord compression (anterior/posterior), the number of levels of stenosis, overall spinal alignment, body habitus and other factors such as prior surgery.

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Section: Recent Controversiesmentioning

confidence: 99%

Section: Recent Controversiesmentioning

confidence: 99%

Section: Recent Controversiesmentioning

confidence: 99%

Section: Recent Controversiesmentioning

confidence: 99%

See 2 more Smart Citations

Cervical Myelopathy: Diagnosis and Surgical Strategies

Paschal,

Zelenty,

Sama

et al. 2023

SurgiColl

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“…Initially, nonoperative conservative interventions are typically employed, but in cases where nonoperative measures are ineffective, surgical intervention may be warranted [ 2 ]. Cervical DDD that is refractory to nonoperative treatment is a common condition encountered by spine surgeons today, and it places a significant cost burden on the healthcare system [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Cervical Disc Arthroplasty (CDA) versus Anterior Cervical Discectomy and Fusion (ACDF) for Two-Level Cervical Disc Degenerative Disease: An Updated Systematic Review and Meta-Analysis

Chen,

Yang,

2024

JCM

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Background: Anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) are both considered to be efficacious surgical procedures for treating cervical spondylosis in patients with or without compression myelopathy. This updated systematic review and meta-analysis aimed to compare the outcomes of these procedures for the treatment of cervical degenerative disc disease (DDD) at two contiguous levels. Methods: The PubMed, EMBASE, and Cochrane CENTRAL databases were searched up to 1 May 2023. Studies comparing the outcomes between CDA and ACDF in patients with two-level cervical DDD were eligible for inclusion. Primary outcomes were surgical success rates and secondary surgery rates. Secondary outcomes were scores on the Neck Disability Index (NDI) and Visual Analogue Scale (VAS) for neck and arm pain, as well as the Japanese Orthopaedic Association (JOA) score for the severity of cervical compression myelopathy and complication rates. Results: In total, eight studies (two RCTs, four retrospective studies, and two prospective studies) with a total of 1155 patients (CDA: 598; ACDF: 557) were included. Pooled results revealed that CDA was associated with a significantly higher overall success rate (OR, 2.710, 95% CI: 1.949–3.770) and lower secondary surgery rate (OR, 0.254, 95% CI: 0.169–0.382) compared to ACDF. In addition, complication rates were significantly lower in the CDA group than in the ACDF group (OR, 0.548, 95% CI: 0.326 to 0.919). CDA was also associated with significantly greater improvements in neck pain VAS than ACDF. No significant differences were found in improvements in the arm VAS, NDI, and JOA scores between the two procedures. Conclusions: CDA may provide better postoperative outcomes for surgical success, secondary surgery, pain reduction, and postoperative complications than ACDF for treating patients with two-level cervical DDD.

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