Improving Awareness Could Transform Outcomes in Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 1]

Author:

Davies Benjamin M.12ORCID,Mowforth Oliver12ORCID,Wood Helen1,Karimi Zahabiya1,Sadler Iwan1,Tetreault Lindsay3,Milligan Jamie4,Wilson Jamie R. F.5,Kalsi-Ryan Sukhvinder67,Furlan Julio C.67ORCID,Kawaguchi Yoshiharu8ORCID,Ito Manabu9,Zipser Carl Moritz10,Boerger Timothy F11ORCID,Vaccaro Alexander R.12,Murphy Rory K. J.13,Hutton Mike14,Rodrigues-Pinto Ricardo1516ORCID,Koljonen Paul A.17ORCID,Harrop James S.18,Aarabi Bizhan19,Rahimi-Movaghar Vafa20,Kurpad Shekar N11,Guest James D.21,Wilson Jefferson R.22ORCID,Kwon Brian K.23,Kotter Mark R. N.12,Fehlings Michael G.22ORCID

Affiliation:

1. Myelopathy.org, International Charity for Degenerative Cervical Myelopathy, Cambridge, UK

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

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

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

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

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

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

8. Department of Orthopaedic Surgery, University of Toyama, Toyama, Japan

9. Department of Orthopaedic Surgery, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan

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

11. Department of Neurosurgery, Medical College of Wisconsin, Wauwatosa, WI, USA

12. Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA

13. Department of Neurosurgery, St. Joseph’s Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, USA

14. Royal Devon and Exeter NHS Foundation Trust, Exeter, UK

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

16. Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal

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

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

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

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

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

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

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

Abstract

Study Design Literature Review (Narrative) Objective To introduce the number one research priority for Degenerative Cervical Myelopathy (DCM): Raising Awareness. Methods Raising awareness has been recognized by AO Spine RECODE-DCM as the number one research priority. This article reviews the evidence that awareness is low, the potential drivers, and why this must be addressed. Case studies of success from other diseases are also reviewed, drawing potential parallels and opportunities for DCM. Results DCM may affect as many as 1 in 50 adults, yet few will receive a diagnosis and those that do will wait many years for it. This leads to poorer outcomes from surgery and greater disability. DCM is rarely featured in healthcare professional training programs and has received relatively little research funding (<2% of Amyotrophic Lateral Sclerosis or Multiple Sclerosis over the last 25 years). The transformation of stroke and acute coronary syndrome services, from a position of best supportive care with occasional surgery over 50 years ago, to avoidable disability today, represents transferable examples of success and potential opportunities for DCM. Central to this is raising awareness. Conclusion Despite the devastating burden on the patient, recognition across research, clinical practice, and healthcare policy are limited. DCM represents a significant unmet need that must become an international public health priority.

Funder

AO Spine Research Department

Publisher

SAGE Publications

Subject

Neurology (clinical),Orthopedics and Sports Medicine,Surgery

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