This protocol applies to patients who have MRI evidence of cervical spinal cord compression and present with neck pain, but who do not show signs of cervical myelopathy and have no signs or symptoms of radiculopathy.
Nonmyelopathic patients have MRI evidence of spinal cord compression and symptoms of neck pain but do not present with signs of myelopathy. This distinguishes them from patients with established myelopathic deficits and shapes the management approach significantly.
The structured evidence-based approach for this scenario involves a non-surgical management strategy focused on patient counseling — including discussion of progression risks and recognition of early warning signs. The complete protocol details the structured follow-up and clinical monitoring framework.
DOI: 10.1177/2192568217703088
Nonmyelopathic patients have MRI evidence of spinal cord compression and symptoms of neck pain but do not present with signs of myelopathy.
We suggest not offering prophylactic surgery for nonmyelopathic patients with evidence of cervical cord compression without signs or symptoms of radiculopathy.
We suggest that these patients be counseled as to potential risks of progression, educated about relevant signs and symptoms of myelopathy, and be followed clinically.
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