The DCM-IS is a modernized index designed to provide a quantified severity assessment for degenerative cervical myelopathy across major functional domains.
Myelopathy Sentinel Probe
Complete the 4-domain functional assessment to quantify the global impact of spinal cord compression and establish a clinical severity grade.
Surgical decision making for anterior or posterior cervical decompression procedures.
Section 2
Literature
Development
Degenerative Cervical Myelopathy (DCM) encompasses cervical spondylotic myelopathy (CSM), OPLL, and related conditions. Functional indexes like mJOA or Nurick have limitations. Composite severity indexes aim to capture the multi-dimensional decline in motor, sensory, autonomic, and gait function. This abstracted scale represents practical clinical parameters for triaging DCM severity.
Section 3
Pearls/Pitfalls
Goal of Surgery
It is critical to counsel patients that the primary goal of surgery for DCM is to HALT PROGRESSION, not necessarily to recover lost function (though recovery can occur). Hence, earlier intervention in mild-moderate cases often yields better long-term functional status than delaying until severe deficits arise.
Section 4
Evidence Appraisal
Primary Reference
A Clinical Practice Guideline for the Management of Patients With Degenerative Cervical Myelopathy: Recommendations for Patients With Mild, Moderate, and Severe Disease and Nonmyelopathic Patients With Evidence of Cord Compression
Fehlings MG et al. • Global Spine J. 2017;7(3 Suppl):70S-83S
