Evidence-based commentary on the diagnosis, management, and further research of degenerative cervical spinal cord compression in the absence of clinical symptoms of myelopathy

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Authors

HORÁK Tomáš HORÁKOVÁ Magda KEŘKOVSKÝ Miloš DOSTÁL Marek HLUSTIK Petr VALOSEK Jan SVATKOVA Alena BEDNARIK Petr VLČKOVÁ Eva BEDNAŘÍK Josef

Year of publication 2024
Type Article in Periodical
Magazine / Source Frontiers in Neurology
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1341371/full
Doi http://dx.doi.org/10.3389/fneur.2024.1341371
Keywords degenerative cervical cord compression; degenerative cervical myelopathy; cervical spinal canal stenosis; magnetic resonance imaging; subclinical myelopathy
Description Degenerative cervical myelopathy (DCM) represents the final consequence of a series of degenerative changes in the cervical spine, resulting in cervical spinal canal stenosis and mechanical stress on the cervical spinal cord. This process leads to subsequent pathophysiological processes in the spinal cord tissues. The primary mechanism of injury is degenerative compression of the cervical spinal cord, detectable by magnetic resonance imaging (MRI), serving as a hallmark for diagnosing DCM. However, the relative resilience of the cervical spinal cord to mechanical compression leads to clinical-radiological discordance, i.e., some individuals may exhibit MRI findings of DCC without the clinical signs and symptoms of myelopathy. This degenerative compression of the cervical spinal cord without clinical signs of myelopathy, potentially serving as a precursor to the development of DCM, remains a somewhat controversial topic. In this review article, we elaborate on and provide commentary on the terminology, epidemiology, natural course, diagnosis, predictive value, risks, and practical management of this condition-all of which are subjects of ongoing debate.
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