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PMID- 28894688
DA  - 20170912
LR  - 20170914
IS  - 2192-5682 (Print)
IS  - 2192-5682 (Linking)
VI  - 7
IP  - 6
DP  - 2017 Sep
TI  - Current Diagnosis and Management of Cervical Spondylotic Myelopathy.
PG  - 572-586
LID - 10.1177/2192568217699208 [doi]
AB  - STUDY DESIGN: Review. OBJECTIVES: Cervical spondylotic myelopathy (CSM) is a
      major cause of disability, particular in elderly patients. Awareness and
      understanding of CSM is imperative to facilitate early diagnosis and management. 
      This review article addresses CSM with regard to its epidemiology, anatomical
      considerations, pathophysiology, clinical manifestations, imaging
      characteristics, treatment approaches and outcomes, and the cost-effectiveness of
      surgical options. METHODS: The authors performed an extensive review of the
      peer-reviewed literature addressing the aforementioned objectives. RESULTS: The
      clinical presentation and natural history of CSM is variable, alternating between
      quiescent and insidious to stepwise decline or rapid neurological deterioration. 
      For mild CSM, conservative options could be employed with careful observation.
      However, surgical intervention has shown to be superior for moderate to severe
      CSM. The success of operative or conservative management of CSM is multifactorial
      and high-quality studies are lacking. The optimal surgical approach is still
      under debate, and can vary depending on the number of levels involved, location
      of the pathology and baseline cervical sagittal alignment. CONCLUSIONS: Early
      recognition and treatment of CSM, before the onset of spinal cord damage, is
      essential for optimal outcomes. The goal of surgery is to decompress the cord
      with expansion of the spinal canal, while restoring cervical lordosis, and
      stabilizing when the risk of cervical kyphosis is high. Further high-quality
      randomized clinical studies with long-term follow up are still needed to further 
      define the natural history and help predict the ideal surgical strategy.
FAU - Bakhsheshian, Joshua
AU  - Bakhsheshian J
AD  - University of Southern California, Los Angeles, CA, USA.
FAU - Mehta, Vivek A
AU  - Mehta VA
AD  - University of Southern California, Los Angeles, CA, USA.
FAU - Liu, John C
AU  - Liu JC
AD  - University of Southern California, Los Angeles, CA, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20170531
PL  - England
TA  - Global Spine J
JT  - Global spine journal
JID - 101596156
PMC - PMC5582708
OT  - anterior cervical discectomy and fusion
OT  - cervical disk replacement
OT  - cervical laminoplasty
OT  - cervical spine stenosis
OT  - cervical spondylosis
OT  - cervical spondylotic myelopathy
OT  - degenerative disc disease
COI - Declaration of Conflicting Interests: The author(s) declared no potential
      conflicts of interest with respect to the research, authorship, and/or
      publication of this article.
EDAT- 2017/09/13 06:00
MHDA- 2017/09/13 06:01
CRDT- 2017/09/13 06:00
AID - 10.1177/2192568217699208 [doi]
AID - 10.1177_2192568217699208 [pii]
PST - ppublish
SO  - Global Spine J. 2017 Sep;7(6):572-586. doi: 10.1177/2192568217699208. Epub 2017
      May 31.