Surgical Outcomes of Degenerative Cervical Myelopathy in Patients with Parkinson Disease: A Systematic Review

Study Design Systematic review. Objectives To synthesize outcomes, complications, and healthcare utilization after surgery for degenerative cervical myelopathy (DCM) in patients with Parkinson disease (PD). Methods PubMed/MEDLINE, EMBASE, and the Cochrane Library were searched from inception to March 2026. Eligible studies evaluated adults with PD undergoing cervical decompression with or without fusion for DCM; studies not specifically defining myelopathy but reporting cervical outcomes within broader PD spine cohorts were retained as indirect supportive evidence. Two reviewers independently screened studies, extracted data, and appraised quality using standard checklists. Because of marked heterogeneity, findings were synthesized narratively, with greater weight given to myelopathy-defined cohorts. Results Eleven studies were included: 5 myelopathy-defined cohorts and 6 supportive studies. In myelopathy-defined cohorts, PD patients improved after surgery, but some studies showed smaller gains in modified Japanese Orthopaedic Association (mJOA) or Nurick scores, lower odds of clinically important mJOA improvement, and less EQ-5D improvement compared with non-PD controls. Database studies showed higher complication rates, longer hospital stays, non-home discharge, and a dysphagia/aspiration signal. Supportive studies suggested similar increases in hospitalization and medical complications and raised concern for long-term mechanical failure or reoperation. Conclusions The most direct evidence suggests that patients with PD undergoing surgery for cervical myelopathy may improve neurologically, although functional recovery may be smaller or less clinically meaningful in some cohorts. Perioperative risk and healthcare utilization also appear higher. Indirect supportive evidence further suggests that dysphagia or aspiration-related events and long-term mechanical failure or reoperation are important concerns in this population.