Overview of Degenerative Cervical Myelopathy

Degenerative Cervical Myelopathy (DCM) is a progressive condition affecting the spinal cord in the neck region, leading to significant neurological deficits. This condition is of great significance due to its potential to cause long-term disability and impact on an individual's quality of life. DCM is a prevalent condition, particularly in older adults, with the prevalence increasing with age.

The impact on health is profound as DCM affects essential functions such as mobility, sensation, and dexterity. In the short term, untreated DCM can lead to pain, weakness, and difficulty in coordination. Long-term risks include permanent neurological deficits and loss of independence. It is important to note that DCM can be asymptomatic in its early stages, highlighting the importance of early detection through regular screenings to prevent progression and irreversible damage.

Causes of Degenerative Cervical Myelopathy

Several factors contribute to the development of Degenerative Cervical Myelopathy.

• Spinal Stenosis - Spinal stenosis is a narrowing of the spinal canal that can compress the spinal cord over time, leading to DCM. This compression causes progressive damage to the spinal cord, resulting in neurological symptoms.
• Intervertebral Disc Degeneration - Degeneration of the intervertebral discs in the cervical spine can lead to the loss of disc height and the development of bone spurs, causing compression of the spinal cord and subsequent DCM.
• Ossification of the Posterior Longitudinal Ligament (OPLL) - OPLL is a condition where ligaments in the spine harden and thicken, potentially causing compression of the spinal cord and contributing to DCM development.
• Cervical Spondylosis - Cervical spondylosis is a degenerative condition of the cervical spine involving the breakdown of spinal discs and the development of bone spurs, which can lead to spinal cord compression and DCM.

Secondary risk factors or lifestyle contributors to DCM include:

• Poor Posture - Prolonged poor posture can contribute to cervical spine degeneration, increasing the risk of developing DCM.
• Sedentary Lifestyle - Lack of physical activity can weaken the supporting structures of the spine, predisposing individuals to DCM.
• Smoking - Smoking has been linked to accelerated degeneration of spinal discs and may increase the risk of developing DCM.

Symptoms of Degenerative Cervical Myelopathy

The symptoms of DCM can vary depending on the stage of the condition.

• Neck pain - Neck pain may be one of the earliest symptoms of DCM, impacting daily activities and causing discomfort.
• Numbness or Tingling - Numbness or tingling in the arms or hands may signal nerve compression in the cervical spine and affect fine motor skills.

Advanced-stage symptoms of DCM may include:

• Muscle Weakness - Muscle weakness in the arms and legs can significantly impact physical abilities and increase the risk of falls.
• Difficulty with Coordination - Impaired coordination can affect daily activities and lead to increased frustration and emotional distress.

Diagnosis of Degenerative Cervical Myelopathy

Diagnosing DCM involves a multi-step process to accurately identify the condition and tailor appropriate treatment.

• MRI (Magnetic Resonance Imaging) - MRI is crucial for visualizing the spinal cord and identifying any compression or abnormalities that may indicate DCM.
• Electromyography (EMG) - EMG assesses the electrical activity of muscles and nerves, helping to determine the extent of nerve damage in DCM.
• X-rays - X-rays can reveal structural changes in the cervical spine, such as bone spurs or disc degeneration, which may contribute to DCM.
• CT (Computed Tomography) Scan - CT scans provide detailed images of the spine, aiding in the evaluation of spinal cord compression and associated abnormalities.

Treatment Options for Degenerative Cervical Myelopathy

Treatment for DCM aims to manage symptoms, prevent progression, and improve overall quality of life.

• Medications - Nonsteroidal anti-inflammatory drugs (NSAIDs) and pain relievers may be prescribed to manage pain and inflammation associated with DCM.
• Physical Therapy - Physical therapy can help improve strength, flexibility, and coordination, enhancing functional abilities in individuals with DCM.
• Surgery - In severe cases of DCM, surgical intervention may be necessary to decompress the spinal cord and stabilize the cervical spine, reducing symptoms and preventing further neurological damage.

By understanding the causes, symptoms, diagnosis, and treatment options for Degenerative Cervical Myelopathy, individuals can take proactive steps to address this condition and improve their overall well-being.

Early detection and intervention are key in managing DCM effectively and preventing long-term complications.