Establishing Diagnostic Criteria for Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 3]

Author:

Hilton Bryn1,Gardner Emma L.2,Jiang Zhilin3,Tetreault Lindsay4,Wilson Jamie R. F.5,Zipser Carl Moritz6,Riew K. Daniel7,Guest James D.8,Harrop James S.9,Fehlings Michael G.10ORCID,Rodrigues-Pinto Ricardo1112ORCID,Rahimi-Movaghar Vafa13,Aarabi Bizhan14,Koljonen Paul A.15ORCID,Kotter Mark R. N.1617,Davies Benjamin M.1617ORCID,Kwon Brian K.18

Affiliation:

1. Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom

2. Colchester Hospital, East Suffolk and North Essex NHS Foundation Trust, Colchester, United Kingdom.

3. Kings College Hospital, Kings College Hospital NHS Foundation Trust, London, United Kingdom

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

5. University of Nebraska Medical Center, Department of Neurosurgery, Omaha, Nebraska, USA

6. University Spine Center, Balgrist University Hospital, Zurich, Switzerland

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

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

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

10. Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada

11. Department of Orthopaedics, Spinal Unit (UVM), Centro Hospitalar Universitário do Porto - Hospital de Santo António, Porto, Portugal

12. Department of Orthopaedics, Instituto de CiM), Centro Hospital, Portugal

13. Department of Neurosurgery, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran

14. Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA

15. Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China

16. Myelopathy.org, International Charity for Degenerative Cervical Myelopathy, United Kingdom

17. Department of Neurosurgery, University of Cambridge, Cambridge, United Kingdom

18. Department of Orthopaedics, University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia, Canada

Abstract

Study Design: Narrative review. Objectives: To discuss the importance of establishing diagnostic criteria in Degenerative Cervical Myelopathy (DCM), including factors that must be taken into account and challenges that must be overcome in this process. Methods: Literature review summarising current evidence of establishing diagnostic criteria for DCM. Results: Degenerative Cervical Myelopathy (DCM) is characterised by a degenerative process of the cervical spine resulting in chronic spinal cord dysfunction and subsequent neurological disability. Diagnostic delays lead to progressive neurological decline with associated reduction in quality of life for patients. Surgical decompression may halt neurologic worsening and, in many cases, improves function. Therefore, making a prompt diagnosis of DCM in order to facilitate early surgical intervention is a clinical priority in DCM. Conclusion: There are often extensive delays in the diagnosis of DCM. Presently, no single set of diagnostic criteria exists for DCM, making it challenging for clinicians to make the diagnosis. Earlier diagnosis and subsequent specialist referral could lead to improved patient outcomes using existing treatment modalities.

Publisher

SAGE Publications

Subject

Neurology (clinical),Orthopedics and Sports Medicine,Surgery

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