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Back to Basics: Degenerative Cervical Myelopathy 

Spine & Nerve
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves discuss Degenerative Cervical Myelopathy (DCM). DCM, previously called cervical spondylotic myelopathy, is defined as neurologic injury to the cervical spinal cord due to various age-related degenerative conditions of the cervical spine resulting in injury to the spinal cord secondary to static compression, and/or dynamic injury due to instability. DCM results in symptoms including loss of hand function / dexterity, imbalance/falls, weakness, numbness, pain, bladder / bowel dysfunction.
DCM is a common disease process- it is the most common cause of spinal cord injury in the developed world. Natural history studies of DCM show that for patients with significant cervical stenosis, the risk of development of DCM is 8% at 1 year, and up to 23% at 3-4 year follow up. Dr. Karadimas and his colleagues found that between 20-60% of patients with initially mild DCM will have significant clinical deterioration over time; as measured by functional outcome measures including Timed 10 meter walk, and ADL’s score. This understanding of the typical natural history of DCM highlights the importance of close monitoring of patients with significant cervical stenosis, and prompt surgical referral once DCM is diagnosed.
Listen as the doctors discuss this important topic including the definition, epidemiology, clinical presentation, diagnosis, and management.
This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve.

References:
1. Lebl, Darren R. MD; Bono, Christopher M. MD Update on the Diagnosis and Management of Cervical Spondylotic Myelopathy, Journal of the American Academy of Orthopaedic Surgeons: November 2015 - Volume 23 - Issue 11 - p 648-660.
2. Nouri A, Cheng JS, Davies B, Kotter M, Schaller K, Tessitore E. Degenerative Cervical Myelopathy: A Brief Review of Past Perspectives, Present Developments, and Future Directions. J Clin Med. 2020;9(2):535.

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15 июн 2024

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Комментарии : 20   
@garydunn3037
@garydunn3037 Месяц назад
My Mother had all of the Above after "Routine" Surgery on her right Knee. I don't what the Hell went on in that Operating room. But she firstly lost the use of her left arm. Then it progressed to her right arm, then her legs, and eventually all her motor functions. And her bladder and back passage functions. Then eventually ended up in her losing even her ability to speak. She was just a "Living Corpse" towards the end of her life. She Passed Away 4 weeks ago. All, for a routine surgery of her right knee.
@pokarpatel707
@pokarpatel707 2 года назад
Super video bro
@user-ge3iy4dt3j
@user-ge3iy4dt3j 10 месяцев назад
Can extensive degenerative spondylosis throughout the cervical region progress to cervical myelopathy?
@Twintouch1
@Twintouch1 2 года назад
What does Chronic compressive myelomalacia and cord atrophy at the C4-C5 level, unchanged compared to preoperative studies mean exactly?
@niccolechandler1519
@niccolechandler1519 Год назад
I have been diagnosed with non compressive cervical myelopathy in C1 and C2 area possibly due to copper deficiency and Ro-N-y gastric bypass I have been having severe neurological problems, and I have lost the ability to walk on my own in about 6 months, my neurologist has never seen anything like this in 30 years of practice and my family doc says the same,I can't find a doctor and my medical team has given up I can travel to anywhere if I could find a doctor.
@niccolechandler1519
@niccolechandler1519 Год назад
Diagnosis came by way of MRI
@kelviannaepperson3677
@kelviannaepperson3677 2 года назад
I have just been told that I was born with neuropathy and the nerve pain has spread over my whole body starting at the feet and hands then back and chest. And I have cerebral palsy already have balance issues and the neuropathy made it worse. A neurosurgeon's nurse was taking to me about premature aging
@EllaBella-76
@EllaBella-76 4 месяца назад
@kevinannaepperson3677 •How can it suddenly do this same with me ?I thank goodness don’t have dreadful pain it’s been gentle ’ was like pins and needles gentle ones now it’s numbness.Thats waking me up ?I am not putting myself up for further surgery but a new body and brain-Yep count me in ?(Mine was compressed C5/C7 on a nerve route well I have had it since I was 38 Years Old original brain injury more brain changes?Caused by ?I have no clue but it’s flipping nightmare I can deal with pain, if you haven’t done other than symptoms like yours my brother is going to advocate for me I have zero desire to go demented my GP is really nice but on top of this it’s stoping all sleep or I am asleep then I can’t sleep I just want to know from him has he any clue I am seeing my GP on Monday my brother has P.O.E.M.S but I have a son I have no family history of this other than we must have dodgy genetics my son is my priority to not tell him until we know exactly what’s going on.I been referred to an Endocrinologist as my hormones?Entire system has gone into some weird behaviour like sodium up sodium down?Sodium more down on D3 and extra sodium but (STRESS?)Strange that ..I been falling over like I am drunk someI can see separately further brain chaos like really bad I feel like I have dementia 😩They kept saying it’s menopause all I know is I shall be radioactive.I thought they where joking with the comment “If the Dr has not phoned by Friday ?After the MRI on the Tuesday,you should phone him ?”Then a CT Scan ?With contrast ?”I think I would rather have menopause only this has sent my hormones and my entire endocrine system including metabolism into overdrive?I been falling over breaking bones but sure is not happy hour here ether .Well I had neck discomfort since 2016 no ability to turn it to the left ?So my GP told me over the phone but offered me face to face(Monday ?) top its all neurology rejected me ?How can it suddenly spread ?Well I had therapist she yanked me round like I was some sort of rubber band made me cry ..Previously they were great I just left this lady I went out .I am not seeing people that cause me huge pain don’t Angoge that maybe it’s best to be gentle when someone can’t turn their neck to the left without screeching .Good Luck ,with this one ..I am exhausted from this because I can’t sleep at night it’s waking me up ..
@sofiazolota8412
@sofiazolota8412 Год назад
Can you have moderate myelopathy without the white spot on the T2 spinal cord image? I have severe arm,hand,leg weakness,loss of balance but my dexterity is not so bad that I can't button a shirt. My last MRI was one year ago where the space for the spinal cord on C5-C6 was 9 mm . Because my EMG was good they diagnosed me with functional neurological disorder.
@ahmadabras2846
@ahmadabras2846 Год назад
Thank you very much . Two years ago, I got a bruise in the cervical spinal cord by mistake from the surgeon during the 5-6 vertebra fusion. I had many problems and then my condition improved after physiotherapy and taking some medications and vitamins. My question is: Why did my condition deteriorate to a bad degree after two years? From the injury and it became a lot worse than before, the neck pain, shoulder pain and arms and severe weakness in the hands and feet have returned. Is there a logical explanation, knowing that I had an MRI and there is no new disk..?
@garydunn3037
@garydunn3037 Месяц назад
You count yourself "Lucky" my Mother had all the above, but ended up a vegetable, unable to move, not even able to speak in the end. I described her as a "Living Corpse" to others. Then she "Passed Away" 4 weeks ago. One Taxi Driver told me, "You wouldn't let an animal suffer like that" End of Story.
@deguzmanaaron
@deguzmanaaron 2 года назад
Do oblique views of the cervical spine add any value to seeing the size of the foramina? Is it possible to get some type of measurement through plain films?
@SpineNerve
@SpineNerve 2 года назад
Oblique views of the cervical spine can definitely show different bony structures, but MR imaging is the standard when myelopathy is a concern
@Rafi-of4vo
@Rafi-of4vo 2 года назад
C2 to C7 spine cervical myelopathy After operation I have no improve
@jimmendola6672
@jimmendola6672 2 года назад
Me too
@mollisworldwithmuralsbymol6977
@mollisworldwithmuralsbymol6977 2 года назад
Surgery is not done to improve your myelopathy it’s to slow down the progression
@themysticmuse
@themysticmuse Год назад
All this is so devastating.😔
@coffeehead68
@coffeehead68 10 месяцев назад
completely@@themysticmuse
@coffeehead68
@coffeehead68 10 месяцев назад
My Dad was told this but also told that any improvement would be a bonus so I can only assume that it is possible.@@mollisworldwithmuralsbymol6977
@renepolanco6881
@renepolanco6881 10 месяцев назад
hes a doctor not a speaker
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