Cervical Spondylotic Myelopathy: Current State of the Art and Future Directions

Study Design. Narrative overview of the focus issue on cervical spondylotic myelopathy (CSM). Objective. To provide an introduction to this special focus issue of Spine journal that deals with CSM. Summary of Background Data. CSM is a progressive spine disease and the leading cause of spinal cord dysfunction worldwide. The shift in population demographics in many parts of the world has motivated the development of this focus issue. With the overall aging of the population, we can predict that global health care systems will be confronted with an increase in patients presenting with degenerative spine changes and various stages of cervical myelopathy. Methods. The articles in this issue vary in their methods—there are systematic reviews, narrative reviews, a study protocol, and 2 primary research articles. Results. A summary of the findings of each article is provided as a table within this introduction. Conclusion. By way of this issue, we have summarized current knowledge gaps and limitations in the evidence to provide direction for future research and investigation. These include the need for a unified nomenclature for referring to CSM, the need to specify the incidence of myelopathy and the prevalence of ossification of the posterior longitudinal ligament, and the need to explore both the safety and efficacy of neuroprotective and neuroreparative pharmacological strategies. Further work is also required to optimize the management of patients with minimal symptoms.