Incidence of degenerative cervical myelopathy: findings from an English population-based study

PURPOSE: Degenerative Cervical Myelopathy (DCM) is the most common form of atraumatic spinal cord compression. Few population estimates have been reported, with most estimates derived from hospital records. The aim was to estimate the incidence of DCM in UK primary care. METHODS: Population cohort study using the Clinical Practice Research Datalink (CPRD) Aurum database of English general practices, restricted to adults aged 20 years and over, 2013-2023. Incidence was calculated as new DCM diagnoses per calendar year divided by the registered adult population at each year's midpoint, reported per 100,000 person-years with 95% CIs, crude and age-standardised (AS), by gender and age band. Trends were modelled using negative binomial regression, examining pre- and post-pandemic periods separately. RESULTS: A total of 10,439 incident DCM cases were identified, from 16,585,135 currently registered patients (average age at diagnosis 61.8 years; 55% male). Overall incidence was 7.9 (95% CI 7.8 to 8.1) per 100 000 person-years, higher in men (AS 9.6, 95% CI 9.3 to 9.8) than women (AS 7.5, 95% CI 7.3 to 7.7) peaking at ages 75-79 years (18.9 95% CI 17.8 to 20.1) per 100,000. Over the study period incidence reduced, but pre-pandemic was absent, and incidence rose significantly after 2020, indicating COVID-19-related diagnostic disruption rather than a true decline. CONCLUSIONS: DCM incidence in UK primary care is higher than previously reported estimates, peaks in older males, and rose significantly after 2020. Primary care clinicians should be aware DCM may be more common than previously assumed.