The following is a summary of “Review of Prospective Trials for Degenerative Cervical Myelopathy” published in the December 2022 issue of Spine Surgery by Satin et al.
Degenerative cervical myelopathy (DCM) is the most common cause of dysfunction in the spinal cord in adults. DCM is an umbrella term for a group of degenerative disorders that affect the cervical canal, leading to malfunction in the nervous system due to the canal’s narrowing. Numerous prospective studies have been conducted to evaluate DCM as a result of both a dearth of high-quality research and a recent rise in awareness regarding public health. Studies that evaluate the efficacy of surgical intervention for DCM can be categorized according to whether or not they include a nonoperative control group by designating it as competitive or noncomparative, respectively.
The preponderance of noncomparative studies can be attributed to the concerns with treatment parity. Methodological challenges have hampered the use of comparative research, and the results of these studies need to be consistent. The efficacy and safety of surgical surgery for DCM, including mild myelopathy, have been confirmed by more recent studies that did not compare the treatment to any other. There is an ongoing debate on which surgical treatment is most effective for DCM.
A recent randomized clinical experiment that compared dorsal and ventral procedures demonstrated comparable gains in patient-reported physical function at early follow-up. Their knowledge of DCM has been significantly expanded as a result of recent prospective research, which has also contributed to the formation of current treatment guidelines.