![]() ![]() Our recommendations were as follows: (1) "We recommend surgical intervention for patients with moderate and severe DCM." (2) "We suggest offering surgical intervention or a supervised trial of structured rehabilitation for patients with mild DCM. A multidisciplinary guideline development group used this information, and their clinical expertise, to develop recommendations for the management of degenerative cervical myelopathy (DCM). The objective of this study is to develop guidelines that outline how to best manage (1) patients with mild, moderate, and severe myelopathy and (2) nonmyelopathic patients with evidence of cord compression with or without clinical symptoms of radiculopathy.įive systematic reviews of the literature were conducted to synthesize evidence on disease natural history risk factors of disease progression the efficacy, effectiveness, and safety of nonoperative and surgical management the impact of preoperative duration of symptoms and myelopathy severity on treatment outcomes and the frequency, timing, and predictors of symptom development. 24 USC Spine Center, Los Angeles, CA, USA.23 Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.22 Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.20 Keio University School of Medicine, Keio, Japan.19 Nagoya University Graduate School of Medicine, Nagoya, Japan.18 Western University, London, Ontario, Canada.17 Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.16 The Centre for Family Medicine, Kitchener, Ontario, Canada.15 Vancouver General Hospital, Vancouver, British Columbia, Canada.14 University of Cambridge, Cambridge, UK.13 University of California at Los Angeles, Los Angeles, CA, USA.12 Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA.11 Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.10 Spectrum Research, Inc, Tacoma, WA, USA.9 National Defense Medical College, Saitama, Japan.8 University of Utah, Salt Lake City, Utah, USA.7 The University of Kansas, Kansas City, KS, USA. ![]() 6 University of Maryland School of Medicine, Baltimore, MD, USA.5 University of Sydney, Sydney, New South Wales, Australia.4 Washington University School of Medicine, St Louis, MO, USA. ![]()
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