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Abstract Details

The Frequency of Symptoms in Patients with a Diagnosis of Degenerative Cervical Myelopathy: Results of a Scoping Review
General Neurology
P5 - Poster Session 5 (11:45 AM-12:45 PM)

The mean time between symptom onset and surgical evaluation is approximately 18 months in DCM. This delay in assessment by a spinal surgeon has detrimental consequences and may result in incomplete postoperative recovery, reduced quality of life and lifelong disability. Developing diagnostic criteria for DCM will facilitate diagnosis and likely reduce the time to referral for surgical assessment

To conduct a scoping review to determine the diagnostic accuracy and frequency of clinical symptoms in patients with degenerative cervical myelopathy (DCM). 

A scoping review was conducted using a database of all primary DCM studies published between 2005 and 2020. Studies were included if they (i) assessed the sensitivity, specificity, positive or negative predictive value or positive or negative likelihood ratio of a symptom using an appropriate control group or (i) reported the frequency of a symptom in a cohort of DCM patients.

This review identified three studies that discussed the diagnostic accuracy of various symptoms and included a control group. An additional 58 reported on the frequency of symptoms in a cohort of patients with DCM. Based on the results of this review, the most frequent symptoms in DCM include unspecified paresthesias (86%), hand numbness (82%) and hand paresthesias (79%). Neck and/or shoulder pain was present in 51% of patients with DCM, whereas a minority had back (19%) or lower extremity pain (10%). With respect to autonomic symptoms, bladder dysfunction was uncommon (38%) although more frequent than bowel (23%) and sexual impairment (4%). Gait impairment is also commonly seen in patients with DCM (72%), with 70% of individuals reporting difficulty climbing.

Patients with DCM present with a variety of symptoms, most commonly hand paresthesias and numbness, gait instability and weakness. A combination of symptoms and clinical signs is likely required to support a diagnosis of DCM along with certain imaging characteristics.
Lindsay Tetreault, MD, PhD (NYU Langone)
Dr. Tetreault has nothing to disclose.
Elina Zakin, MD (NYU Grossman School of Medicine) The institution of Dr. Zakin has received research support from American Board of Psychiatry and Neurology.