4.4 Article

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

Journal

GLOBAL SPINE JOURNAL
Volume 12, Issue 1_SUPPL, Pages 64S-77S

Publisher

SAGE PUBLICATIONS LTD
DOI: 10.1177/21925682211063854

Keywords

degenerative cervical myelopathy; cervical spondylotic myelopathy; ossification of the posterior longitudinal ligament; clinician-reported outcome measures; patient-reported outcome measures; monitoring; outcome assessment

Funding

  1. AO Spine through the AO Spine Knowledge Forum Spinal Cord Injury, a focused group of international Spinal Cord Injury experts
  2. AO Spine Research Department
  3. National Institute for Health Research (NIHR) Brain Injury MedTech Co-operative
  4. NIHR

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DCM is a disease caused by progressive injury to the cervical spinal cord due to age-related changes. Effective monitoring of the population will require establishing a monitoring framework and developing new assessment tools.
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.

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