Tetreault Lindsay A, Karadimas Spyridon, Wilson Jefferson R, Arnold Paul M, Kurpad Shekar, Dettori Joseph R, Fehlings Michael G
Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
University College Cork, Cork, Ireland.
Global Spine J. 2017 Sep;7(3 Suppl):28S-34S. doi: 10.1177/2192568217700396. Epub 2017 Sep 5.
Systematic review (update).
Degenerative cervical myelopathy (DCM) is a degenerative spine disease and the most common cause of spinal cord dysfunction in adults worldwide. The objective of this study is to determine the natural history of DCM by updating the systematic review by Karadimas et al. The specific aims of this review were (1) to describe the natural history of DCM and (2) to determine potential risk factors of disease progression.
An updated search based on a previous protocol was conducted in PubMed and the Cochrane Collaboration library for studies published between November 2012 and February 15, 2015.
The updated search yielded 3 additional citations that met inclusion criteria and reported the incidence of spinal cord injury and severe disability in patients with DCM. Based on 2 retrospective cohort studies, the incidence rate of hospitalization for spinal cord injury is 13.9 per 1000 person-years in patients with cervical spondylotic myelopathy and 4.8 per 1000 person-years in patients with myelopathy secondary to ossification of the posterior longitudinal ligament (OPLL). In a third small prospective study, the risk of being wheelchair bound or bedridden was 66.7% in DCM patients with OPLL.
The overall level of evidence for these estimated rates of hospitalization following spinal cord injury was rated as low.
系统评价（更新版）。
退行性颈椎脊髓病（DCM）是一种退行性脊柱疾病，是全球成年人脊髓功能障碍最常见的原因。本研究的目的是通过更新Karadimas等人的系统评价来确定DCM的自然史。本评价的具体目的是：（1）描述DCM的自然史；（2）确定疾病进展的潜在危险因素。
基于先前的方案，在PubMed和Cochrane协作图书馆中对2012年11月至2015年2月15日发表的研究进行更新检索。
更新检索产生了另外3篇符合纳入标准的引文，报告了DCM患者脊髓损伤和严重残疾的发生率。基于2项回顾性队列研究，脊髓型颈椎病患者脊髓损伤住院发生率为每1000人年13.9例，后纵韧带骨化（OPLL）继发脊髓病患者为每1000人年4.8例。在第三项小型前瞻性研究中，OPLL型DCM患者需要轮椅辅助或卧床的风险为66.7%。
这些估计的脊髓损伤后住院率的总体证据水平被评为低水平。
