Improving Assessment of Disease Severity and Strategies for Monitoring Progression in Degenerative Cervical Myelopathy [AO Spine RECODE DCM Research Priority Number 4]

Author:

Tetreault Lindsay1,Garwood Philip2,Gharooni Aref-Ali3ORCID,Touzet Alvaro Yanez4ORCID,Nanna-Lohkamp Laura5,Martin Allan6,Wilson Jefferson5ORCID,Harrop James S.7,Guest James8,Kwon Brian K.9,Milligan James10,Arizala Alberto Martinez11,Riew K. Daniel12,Fehlings Michael G.5ORCID,Kotter Mark RN.13,Kalsi-Ryan Sukhvinder1415,Davies Benjamin13ORCID

Affiliation:

1. Department of Neurology, Langone Health, Graduate Medical Education, New York University, New York, NY, USA

2. Graduate Medical Education, Internal Medicine, University of Toronto, Toronto, ON, Canada

3. Neurosurgery Unit, Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK

4. The University of Manchester, Manchester, UK

5. Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada

6. Department of Neurosurgery, University of California Davis, Sacramento, CA, USA

7. Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, USA

8. Department of Neurosurgery and The Miami Project to Cure Paralysis, The Miller School of Medicine, University of Miami, Miami, FL, USA

9. Vancouver Spine Surgery Institute, Department of Orthopedics, The University of British Columbia, Vancouver, BC, Canada

10. McMaster University Department of Family Medicine, Hamilton, ON, Canada

11. The Miami Project to Cure Paralysis, The Miller School of Medicine University of Miami, Miami, FL, USA

12. Department of Orthopaedics, The Och Spine Hospital at New York-Presbyterian, Columbia University Medical Center, New York, NY, USA

13. Department of Neurosurgery, University of Cambridge, Cambridge, UK

14. KITE Research Institute, University Health Network, Toronto, ON, Canada

15. Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada

Abstract

Study design Narrative Review. Objective To (i) discuss why assessment and monitoring of disease progression is critical in Degenerative cervical myelopathy (DCM); (ii) outline the important features of an ideal assessment tool and (iii) discuss current and novel strategies for detecting subtle deterioration in DCM. Methods Literature review Results Degenerative cervical myelopathy is an overarching term used to describe progressive injury to the cervical spinal cord by age-related changes of the spinal axis. Based on a study by Smith et al (2020), the prevalence of DCM is approximately 2.3% and is expected to rise as the global population ages. Given the global impact of this disease, it is essential to address important knowledge gaps and prioritize areas for future investigation. As part of the AO Spine RECODE-DCM (Research Objectives and Common Data Elements for Degenerative Cervical Myelopathy) project, a priority setting partnership was initiated to increase research efficiency by identifying the top ten research priorities for DCM. One of the top ten priorities for future DCM research was: What assessment tools can be used to evaluate functional impairment, disability and quality of life in people with DCM? What instruments, tools or methods can be used or developed to monitor people with DCM for disease progression or improvement either before or after surgical treatment? Conclusions With the increasing prevalence of DCM, effective surveillance of this population will require both the implementation of a monitoring framework as well as the development of new assessment tools.

Funder

AO Spine Research Department

National Institute for Health Research

Publisher

SAGE Publications

Subject

Neurology (clinical),Orthopedics and Sports Medicine,Surgery

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