{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T04:25:40Z","timestamp":1793679940542,"version":"4.5.1"},"reference-count":88,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Systematic Review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Degenerative cervical myelopathy (DCM) or cervical spondylotic myelopathy (CSM) is a progressive neurological condition linked to cervical degeneration, often presenting with a wide range of symptoms that complicate diagnosis. This study aims to identify clinical, radiological, and electrophysiological measures that aid in early DCM diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA guidelines a systematic review was performed. Literature from PubMed, Scopus, and the Cochrane Library up to November 2025 was analyzed. Search terms included \u201cdegenerative cervical myelopathy\u201d, \u201ccervical spondylotic myelopathy\u201d, \u201cCSM\u201d, \u201cEarly clinical signs\u201d, \u201cDiffusion Tensor Imaging\u201d, \u201cFractional anisotropy\u201d, \u201cMotor-evoked potentials\u201d, \u201cSensory-evoked potentials\u201d. The included studies primarily focused on clinical examinations, radiological imaging, and electrophysiological tests to detect early signs of DCM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 36 met the inclusion criteria, involving 4596 patients. Tests for \u201cmyelopathy hand\u201d signs showed high negative predictive values in excluding DCM. Lower limb assessments, such as the ten-second step test and Rossolimo reflex, also showed promise for early diagnosis. Among imaging techniques, DTI outperformed traditional T2-weighted Magnetic Resonance Imaging (MRI) in sensitivity, specificity, and predictive value. Kinematic CT myelography (CMCT) also demonstrated potential for early detection. Electrophysiological tests, including SEPs and MEPs, provided valuable insights into disease severity when performed both statically and dynamically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DCM\u2019s variable profile complicates diagnosis. This review highlights the importance of underused clinical evaluations for earlier detection, with DTI showing promise for early changes and preventive use. Electrophysiological measures, non-invasive and accurate, should be integrated alongside dynamic evaluations for a comprehensive, multi-modal diagnostic approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261437765","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T17:48:46Z","timestamp":1774979326000},"page":"4130-4148","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Diagnosis of Degenerative Cervical Myelopathy: A Systematic Review of Current Evidence"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8566-8952","authenticated-orcid":false,"given":"Fabrizio","family":"Russo","sequence":"first","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio-Medico"},{"name":"Universit\u00e0 Campus Bio-Medico di Roma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Brigato","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio-Medico"},{"name":"Universit\u00e0 Campus Bio-Medico di Roma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4140-738X","authenticated-orcid":false,"given":"Giuseppe Francesco","family":"Papalia","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio-Medico"},{"name":"Universit\u00e0 Campus Bio-Medico di Roma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00f2","family":"Fazzi","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio-Medico"},{"name":"Universit\u00e0 Campus Bio-Medico di Roma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Foglia","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio-Medico"},{"name":"Universit\u00e0 Campus Bio-Medico di Roma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7142-1660","authenticated-orcid":false,"given":"Gianluca","family":"Vadal\u00e0","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio-Medico"},{"name":"Universit\u00e0 Campus Bio-Medico di Roma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Papalia","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio-Medico"},{"name":"Universit\u00e0 Campus Bio-Medico di Roma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Denaro","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio-Medico"},{"name":"Universit\u00e0 Campus Bio-Medico di Roma"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000000397"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/10790268.2019.1617920"},{"key":"e_1_3_3_4_2","first-page":"395","article-title":"[Cervical spondylotic myelopathy]","volume":"96","author":"Lohnert J","year":"1995","unstructured":"Lohnert J, L\u00e1tal J. 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