Rodrigues-Pinto Ricardo, Montenegro Thiago S, Davies Benjamin M, Kato So, Kawaguchi Yoshiharu, Ito Manabu, Zileli Mehmet, Kwon Brian K, Fehlings Michael G, Koljonen Paul A, Kurpad Shekar N, Guest James D, Aarabi Bizhan, Rahimi-Movaghar Vafa, Wilson Jefferson R, Kotter Mark R N, Harrop James S
Spinal Unit (UVM), Department of Orthopaedics, 112085Centro Hospitalar Universitário do Porto - Hospital de Santo António, Porto, Portugal.
Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal.
Global Spine J. 2022 Feb;12(1_suppl):147S-158S. doi: 10.1177/21925682211062494.
Literature Review (Narrative).
To introduce the number 10 research priority for Degenerative Cervical Myelopathy: Individualizing Surgery.
This article summarizes the current recommendations and indications for surgery, including how known prognostic factors such as injury time, age, disease severity, and associated comorbidities impact surgical outcome. It also considers key areas of uncertainty that should be the focus of future research.
While a small proportion of conservatively managed patients may remain stable, the majority will deteriorate over time. To date, surgical decompression is the mainstay of treatment, able to halt disease progression and improve neurologic function and quality of life for most patients. Whilst this recognition has led to recommendations on when to offer surgery, there remain many uncertainties including the type of surgery, or timing in milder and/or asymptomatic cases. Their clarification has the potential to transform outcomes, by ensuring surgery offers each individual its maximum benefit.
Developing the evidence to better guide surgical decision-making at the individual patient level is a research priority for Degenerative Cervical Myelopathy.
文献综述（叙述性）。
介绍退行性颈椎脊髓病的首要研究重点：手术个体化。
本文总结了当前的手术推荐和指征，包括损伤时间、年龄、疾病严重程度和相关合并症等已知预后因素如何影响手术结果。它还考虑了未来研究应关注的关键不确定领域。
虽然一小部分接受保守治疗的患者可能保持稳定，但大多数患者会随着时间推移而恶化。迄今为止，手术减压是主要治疗方法，能够阻止疾病进展并改善大多数患者的神经功能和生活质量。尽管这一认识已产生关于何时进行手术的推荐，但仍存在许多不确定性，包括手术类型以及病情较轻和/或无症状病例的手术时机。通过确保手术为每个个体带来最大益处，澄清这些问题有可能改变治疗结果。
为更好地指导个体患者层面的手术决策提供证据是退行性颈椎脊髓病的一项研究重点。
