Současný management pa­cientů s degenerativní kompresí krční míchy

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Title in English Current management of patients with degenerative cervical spine compres­sion
Authors

KADAŇKA Zdeněk HORÁK Tomáš BEDNAŘÍK Josef

Year of publication 2019
Type Article in Periodical
Magazine / Source Ceska a slovenska neurologie a neurochirurgie
MU Faculty or unit

Faculty of Medicine

Citation
Web http://dx.doi.org/10.14735/amcsnn2019632
Doi http://dx.doi.org/10.14735/amcsnn2019632
Keywords degenerative cervical myelopathy; asymptomatic degenerative cervical cord compression; spinal cervical stenosis
Description Degenerative cervical myelopathy (DCM) is the most serious consequence of cervical spinal stenosis (CS) and degenerative cervical spinal cord compres­sion. The spinal cord, however, is quite resistant especially to gradual, chronic mechanical compres­sion. Asymptomatic degenerative cervical cord compression (ADCCC), which is characterized by cervical cord compression in medical imaging techniques, but without clinical signs of myelopathy, is therefore very common. In patients with moderate and severe DCM, surgical intervention is strongly recom­mended. However, in patients with mild DCM and ADCCC, there is no clear, evidence-based agreement on the management and treatment algorithm. Currently, a lot of predictors of ADCC progression to symptomatic DCM have been identified and this has led some surgeons to recommend early decompression surgery in these high-risk patients. However, further studies are required to refine our understanding of the importance of these predictors. Moreover, there are some methodological and ethical challenges that make multicentre randomized study in ADCCC and mild DCM patients difficult to realize. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.
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