{Reference Type}: Journal Article
{Title}: Degenerative Cervical Myelopathy: Development and Natural History [AO Spine RECODE-DCM Research Priority Number 2].
{Author}: Nouri A;Tessitore E;Molliqaj G;Meling T;Schaller K;Nakashima H;Yukawa Y;Bednarik J;Martin AR;Vajkoczy P;Cheng JS;Kwon BK;Kurpad SN;Fehlings MG;Harrop JS;Aarabi B;Rahimi-Movaghar V;Guest JD;Davies BM;Kotter MRN;Wilson JR;
{Journal}: Global Spine J
{Volume}: 12
{Issue}: 1
{Year}: Feb 2022
{Factor}: 2.23
{DOI}: 10.1177/21925682211036071
{Abstract}: <B>METHODS: </B>Narrative review.<BR><B>OBJECTIVE: </B>To discuss the current understanding of the natural history of degenerative cervical myelopathy (DCM).<BR><B>METHODS: </B>Literature review summarizing current evidence pertaining to the natural history and risk factors of DCM.<BR><B>RESULTS: </B>DCM is a common condition in which progressive arthritic disease of the cervical spine leads to spinal cord compression resulting in a constellation of neurological symptoms, in particular upper extremity dysfunction and gait impairment. Anatomical factors including cord-canal mismatch, congenitally fused vertebrae and genetic factors may increase individuals' risk for DCM development. Non-myelopathic spinal cord compression (NMSCC) is a common phenomenon with a prevalence of 24.2% in the healthy population, and 35.3% among individuals >60 years of age. Clinical radiculopathy and/or electrophysiological signs of cervical cord dysfunction appear to be risk factors for myelopathy development. Radiological progression of incidental Ossification of the Posterior Longitudinal Ligament (OPLL) is estimated at 18.3% over 81-months and development of myelopathy ranges between 0-61.5% (follow-up ranging from 40 to 124 months between studies) among studies. In patients with symptomatic DCM undergoing non-operative treatment, 20-62% will experience neurological deterioration within 3-6 years.<BR><B>CONCLUSIONS: </B>Current estimates surrounding the natural history of DCM, particularly those individuals with mild or minimal impairment, lack precision. Clear predictors of clinical deterioration for those treated with non-operative care are yet to be identified. Future studies are needed on this topic to help improve treatment counseling and clinical prognostication.