Türk Nöroşirürji Dergisi 2022 , Vol 32 , Num 3
Rehabilitation in Degenerative Cervical Myelopathy
1Koç Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbul, Türkiye Degenerative cervical myelopathy, which is caused by spinal cord compression after spondylotic changes in the cervical spine, impairs quality of life. Depending on the level and severity of spinal cord compression, various clinical findings are seen; ranging from pain, weakness, sensory abnormalities, spasticity, and gait abnormalities. Early diagnosis and treatment are important because the symptoms can be progressive and better results are seen with treatment within the first year.

The severity of myelopathy is determined by the history, examination, imaging, and clinical scoring. A treatment plan is created considering the rate of progression. Guidelines recommend surgery or supervised structured rehabilitation for mild degenerative cervical myelopathy. If there is no improvement or progression with rehabilitation, surgery is recommended. There are no studies with a sufficient level of evidence for conservative treatment; however, rehabilitation is applied to control pain, maintain muscle strength and endurance, and improve walking. Rehabilitation alleviates symptoms and improves independence in activities of daily living; it also solves secondary problems such as neurogenic bowel and bladder dysfunction, neuropathic pain, spasticity, and osteoporosis. Conservative treatment includes bed rest, pharmacological treatment, injections, physical therapy modalities, cervical traction, exercise, and brace use.

Conservative treatment provides good results in some patients with mild myelopathy. It should not be forgotten that the patients should be followed up regularly in terms of progression. The necessity of rehabilitation should be considered in patients who cannot undergo surgery due to various comorbidities and in patients with post-operative loss of muscle strength or mobility difficulties. Anahtar Kelimeler : Degenerative cervical myelopathy, Cervical spondylotic myelopathy, Rehabilitation, Conservative, Exercise