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  • Predictors of Diagnosis and Development of Cervical Spondylotic Myelopathy: Results of a Systematic Review

    Final Number:

    Anoushka Singh; Lindsay Tetreault Bsc; Michael G. Fehlings MD PhD FRCSC FACS

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2012 Annual Meeting

    Introduction: To conduct a systematic review of the literature to determine any sociodemographic, clinical, radiographic or genetic risk factors associated with the development or diagnosis of degenerative cervical spondylotic myelopathy (CSM).

    Methods: A literature search was conducted using MEDLINE, MEDLINE in Process, EMBASE and Cochrane Database for Systematic Reviews. Abstracts obtained from the initial search were sorted based on pre-determined inclusion and exclusion criteria by two independent reviewers. The quality of evidence of each article was evaluated using a modified SIGN scale.

    Results: The initial search yielded 594 citations. Fourteen of these articles met all inclusion and exclusion criteria and were included in this study. Of these 14, nine provided predictors for diagnosis, three for development, 3 for severity and two for progression of CSM. The major findings from this review are that prolonged MEPs and SEPs, decreased spinal canal diameter, small Torg-Pavlov ratio and age are risk factors for the diagnosis of CSM and that there is a genetic predisposition for the development of CSM.

    Conclusions: Based on this review, we have identified the most important risk factors for the development and diagnosis of CSM. Identification of these factors will allow clinicians to monitor their high-risk patients and implement appropriate management strategies.

    Patient Care: Since CSM has an insidious manifestation, it would be invaluable to determine risk factors associated with its development. Identification of these factors will help physicians determine which patients are most likely to develop CSM in the future, allowing them to implement appropriate management programs.

    Learning Objectives: See above


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