Degenerative Cervical Myelopathy: Natural History, Clinical Presentation, Current Diagnosis and Treatment Review

Abstract

Degenerative cervical myelopathy is a chronic, nontraumatic compression and progressive disease of the cervical spinal cord. Osteoarthritic degeneration (spondylosis, facet hypertrophy, degenerative disc disease), ligament changes (ossification of the posterior longitudinal ligament, hypertrophy of the ligamentum flavum) and ischemia (secondary ischemic injury) may lead to spinal cord compression and result in neurological deficits. Clinically, the appendicular function is mainly affected, as well as gait and urinary function. Duration and degrees of compression are negatively correlated with prognosis. Non-operative treatment can be performed in mild symptomatic cases; however, surgical treatment may possibly improve the natural course of cervical myelopathy disease by stopping progression or avoiding deterioration and, in some cases, restoring some neurological function.