Neurol. praxi. 2023;24(1):12-16 | DOI: 10.36290/neu.2022.061

Degenerative cervical myelopathy - clinical manifestation, diagnosis and practical management

MUDr. Zdeněk Kadaňka, Ph.D., prof. MUDr. Josef Bednařík, CSc.

Neurologická klinika LF MU a FN Brno

Degenerative cervical myelopathy (DCM) is a chronic progressive disease of the cervical spinal cord. Osteoarthritic degeneration (spondylosis, facet hypertrophy, and degenerative disc disease), ligament changes (ossification of the posterior longitudinal ligament, hypertrophy of the ligamentum flavum) may lead to the spinal cord compression and result in neurological deficits. It is manifested as clumsy hands syndrome, gait impairment, and bladder problems. The latest clinical guidelines recommend surgery for patients with moderate and severe DCM. For patients with mild DCM (or non-myelopathic patients with radiculopathy), the guidelines suggest that either surgery or a supervised trial of structured rehabilitation. The nonoperative treatment with serial clinical follow-up should be reserved for asymptomatic patients with imaging evidence of cervical spinal cord compression.

Keywords: degenerative cervical myelopath, cervical spinal stenosis, non­‑myelopathic degenerative cervical spinal cord compression, clumsy hand syndrome.

Received: August 29, 2022; Revised: October 3, 2022; Accepted: October 5, 2022; Prepublished online: October 5, 2022; Published: March 3, 2023  Show citation