• Hao Yuan, Fei Ye, Qinzhong Zhou, Xiaolan Feng, Lipeng Zheng, Ting You, Renping Cao, and Daxiong Feng.
• Department of Spinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China.
• World Neurosurg. 2022 May 1; 161: e154-e161.

BackgroundPatients with degenerative cervical myelopathy (DCM) often present with atypical symptoms such as vertigo, headache, palpitations, tinnitus, blurred vision, memory loss, and abdominal discomfort. This study aims to investigate the relationship between atypical symptoms of DCM and the segments of spinal cord compression.MethodsThe 166 DCM patients with atypical symptoms admitted to our institution from 2019 to 2020 were divided into vertigo, headache, blurred vision, tinnitus, and palpitations groups according to their atypical symptoms, while the typical group was 214 DCM patients with typical symptoms only. Differences in segments of compression were compared among the groups. Results of more than 1-year of follow-up were further summarized for nonsurgical and surgical treatment of DCM patients with atypical symptoms.ResultsThe incidence of vertigo, headache, blurred vision, tinnitus, and palpitations of all DCM patients was 37%, 18%, 15%, 11%, and 11%, respectively. Compared with the typical group, patients in the blurred vision and tinnitus group were older (P < 0.05) and the incidence of spinal cord compression at C3-5 in the vertigo group, C4-5 in the headache group, and C6-7 in the palpitation group was higher (P < 0.05). The scores of vertigo, headache, and palpitations decreased after surgical decompression (P < 0.05), whereas only vertigo and headache scores decreased after nonsurgical treatment (P < 0.05).ConclusionsAtypical symptoms were common in patients with DCM, and the segments of spinal cord compression might be associated with specific atypical symptoms. Surgical treatment is effective in relieving some of the atypical symptoms.Copyright © 2022 Elsevier Inc. All rights reserved.

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