Balmaceno-Criss Mariah, Singh Manjot, Daher Mohammad, Buchbinder Rachelle, Diebo Bassel G, Daniels Alan H
Department of Orthopedics, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
Musculoskeletal Health and Wiser Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia.
J Clin Med. 2024 Nov 25;13(23):7139. doi: 10.3390/jcm13237139.
: Degenerative cervical myelopathy is a progressive neurological disorder that is commonly encountered in clinical practice and its incidence is expected to increase alongside the aging population. Given the importance of early and accurate diagnosis in this patient population, this narrative review aims to provide a repository of up-to-date information regarding pertinent patient history, physical exam findings, and potential alternate diagnoses. : The PubMed database was queried for publications from 1 January 2019 to 19 March 2024. The search terms utilized are as follows: cervical myelopathy", "cervical spondylotic myelopathy", "degenerative cervical myelopathy", "epidemiology", "prevalence", "incidence", "etiology", "diagnosis", "differential", "symptoms", "clinical presentation", and "atypical symptoms". The resultant articles were reviewed for relevance and redundancy and are presented within the following categories: Natural History, Epidemiology, Clinical Presentation, Diagnosis, and Management. : Myelopathy patients often present with subtle and non-specific symptoms such as sleep disturbances, increased falls, and difficulty driving, which can lead to underdiagnosis and misdiagnosis. Failing to diagnose degenerative cervical myelopathy in a timely manner can result in progressive and irreparable neurological damage. Although many nonoperative treatment modalities are available, surgical decompression is ultimately recommended in most cases to limit further deterioration in neurological function and optimize long-term patient outcomes. : A thorough clinical history and physical examination remain the most important diagnostic tools to avoid misdiagnosis and implement early treatment in this patient population.
退行性颈椎脊髓病是一种在临床实践中常见的进行性神经疾病，随着人口老龄化，其发病率预计会上升。鉴于早期准确诊断对该患者群体的重要性，本叙述性综述旨在提供有关相关患者病史、体格检查结果和潜在替代诊断的最新信息库。：在PubMed数据库中查询了2019年1月1日至2024年3月19日的出版物。使用的搜索词如下：“颈椎脊髓病”、“颈椎病性脊髓病”、“退行性颈椎脊髓病”、“流行病学”、“患病率”、“发病率”、“病因学”、“诊断”、“鉴别诊断”、“症状”、“临床表现”和“非典型症状”。对所得文章进行相关性和重复性审查，并按以下类别呈现：自然史、流行病学、临床表现、诊断和治疗。：脊髓病患者常出现睡眠障碍、跌倒增加和驾驶困难等细微且非特异性的症状，这可能导致漏诊和误诊。未能及时诊断退行性颈椎脊髓病可能导致进行性且不可修复的神经损伤。尽管有许多非手术治疗方法，但在大多数情况下最终建议进行手术减压，以限制神经功能的进一步恶化并优化患者的长期预后。：全面的临床病史和体格检查仍然是避免误诊并对该患者群体实施早期治疗的最重要诊断工具。
