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2017 ; 7
(3 Suppl
): 21S-27S
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English Wikipedia
A Clinical Practice Guideline for the Management of Degenerative Cervical
Myelopathy: Introduction, Rationale, and Scope
#MMPMID29164027
Fehlings MG
; Tetreault LA
; Riew KD
; Middleton JW
; Wang JC
Global Spine J
2017[Sep]; 7
(3 Suppl
): 21S-27S
PMID29164027
show ga
Degenerative cervical myelopathy (DCM) is a progressive spine disease and the
most common cause of spinal cord dysfunction in adults worldwide. Patients with
DCM may present with common signs and symptoms of neurological dysfunction, such
as paresthesia, abnormal gait, decreased hand dexterity, hyperreflexia, increased
tone, and sensory dysfunction. Clinicians across several specialties encounter
patients with DCM, including primary care physicians, rehabilitation specialists,
therapists, rheumatologists, neurologists, and spinal surgeons. Currently, there
are no guidelines that outline how to best manage patients with mild (defined as
a modified Japanese Orthopedic Association (mJOA) score of 15-17), moderate (mJOA
= 12-14), or severe (mJOA ? 11) myelopathy, or nonmyelopathic patients with
evidence of cord compression. This guideline provides evidence-based
recommendations to specify appropriate treatment strategies for these
populations. The intent of our recommendations is to (1) help identify patients
at high risk of neurological deterioration, (2) define the role of nonoperative
and operative management in each patient population, and (3) determine which
patients are most likely to benefit from surgical intervention. The ultimate goal
of these guidelines is to improve outcomes and reduce morbidity in patients with
DCM by promoting standardization of care and encouraging clinicians to make
evidence-informed decisions.