Asian populations have a higher rate of ossification of the posterior longitudinal ligament
(OPLL), which can result in myelopathy.
Degenerative cervical myelopathy (DCM) has a number of risk factors, which include
smoking due to its effects on the intervertebral discs , genetics
and occupation - those exposing patients to high axial loading [
The presentation of DCM is very variable (option D, false). Early symptoms are often
subtle and can vary in severity day to day, making the disease difficult to detect initially.
However as a progressive condition, worsening, deteriorating or new symptoms should
be a warning sign.
DCM symptoms can include any combination of :
Pain (affecting the neck, upper or lower limbs)
Loss of motor function (loss of digital dexterity, preventing simple tasks such as holding a
fork or doing up their shirt buttons, arm or leg weakness/stiffness leading to impaired
gait and imbalance
Loss of sensory function causing numbness
Loss of autonomic function (urinary or faedcal incontinence and/or impotence) - these can occur and do not necessarily suggest cauda equina syndrome in the absence of other
hallmarks of that condition
The most common symptoms at presentation of DCM are unknown, but in one series 50%
of patients were initially incorrectly diagnosed and sometimes treated for carpal tunnel