A clinical practice guideline for the management of degenerative cervical myelopathy: introduction, rationale, and scope
Loading...
Files
Published Version
Date
2017
Authors
Fehlings, Michael G.
Tetreault, Lindsay A.
Riew, K. Daniel
Middleton, James W.
Wang, Jeffrey C.
Journal Title
Journal ISSN
Volume Title
Publisher
Sage Publications
Published Version
Abstract
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 evidencebased 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.
Description
Keywords
Cervical spondylotic myelopathy , Degenerative cervical myelopathy , Guideline development , Guidelines
Citation
Fehlings, M. G., Tetreault, L. A., Riew, K. D., Middleton, J. W. and Wang, J. C. (2017) 'A clinical practice guideline for the management of degenerative cervical myelopathy: introduction, rationale, and scope', Global Spine Journal, 7(3s), pp. 21-27. doi: 10.1177/2192568217703088