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

Lindsay Tetreault; Philip Garwood; Aref-Ali Gharooni; Alvaro Yanez Touzet; Laura Nanna-Lohkamp; Allan Martin; Jefferson Wilson; James S Harrop; James Guest; Brian K Kwon; James Milligan; Alberto Martinez Arizala; K Daniel Riew; Michael G Fehlings; Mark R N Kotter; Sukhvinder Kalsi-Ryan; Benjamin M Davies

doi:10.1177/21925682211063854

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

Global Spine J. 2022 Feb;12(1_suppl):64S-77S. doi: 10.1177/21925682211063854. Epub 2021 Dec 31.

Authors

Lindsay Tetreault¹, Philip Garwood², Aref-Ali Gharooni³, Alvaro Yanez Touzet⁴, Laura Nanna-Lohkamp⁵, Allan Martin⁶, Jefferson Wilson⁵, James S Harrop⁷, James Guest⁸, Brian K Kwon⁹, James Milligan¹⁰, Alberto Martinez Arizala¹¹, K Daniel Riew¹², Michael G Fehlings⁵, Mark R N Kotter¹³, Sukhvinder Kalsi-Ryan^{14

15}, Benjamin M Davies¹³

Affiliations

¹ Department of Neurology, Langone Health, Graduate Medical Education, 5894New York University, New York, NY, USA.
² Graduate Medical Education, Internal Medicine, 7938University of Toronto, Toronto, ON, Canada.
³ Neurosurgery Unit, Department of Clinical Neuroscience, 2152University of Cambridge, Cambridge, UK.
⁴ 5292The University of Manchester, Manchester, UK.
⁵ Division of Neurosurgery, Department of Surgery, 7938University of Toronto, Toronto, ON, Canada.
⁶ Department of Neurosurgery, 8789University of California Davis, Sacramento, CA, USA.
⁷ Department of Neurological Surgery, 6559Thomas Jefferson University, Philadelphia, PA, USA.
⁸ Department of Neurosurgery and The Miami Project to Cure Paralysis, The Miller School of Medicine, 12235University of Miami, Miami, FL, USA.
⁹ Vancouver Spine Surgery Institute, Department of Orthopedics, The University of British Columbia, Vancouver, BC, Canada.
¹⁰ 3710McMaster University Department of Family Medicine, Hamilton, ON, Canada.
¹¹ The Miami Project to Cure Paralysis, 12235The Miller School of Medicine University of Miami, Miami, FL, USA.
¹² Department of Orthopaedics, The Och Spine Hospital at New York-Presbyterian, 5798Columbia University Medical Center, New York, NY, USA.
¹³ Department of Neurosurgery, 151895University of Cambridge, Cambridge, UK.
¹⁴ KITE Research Institute, University Health Network, Toronto, ON, Canada.
¹⁵ Department of Medicine, Division of Physical Medicine and Rehabilitation, 7938University 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.

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