Management of the Patient with Cervical Cord Compression but no Evidence of Myelopathy: What Should We do?

Degenerative cervical myelopathy (DCM) eventually affects not only activities of daily living but also quality of life. DCM is usually a gradually progressive, sometimes irreversible, disease of the cervical spinal cord, although there is always a risk of acute deterioration caused by minor trauma. There is still not enough evidence regarding the prognosis of mild DCM without surgical treatment, and conservative treatment seems a reasonable option, although patients need to be followed closely because some do deteriorate over time. Surgeons need to understand, however, the importance of decision making in the surgical management of mild DCM.