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

Global Spine Journal, 2022 · DOI: 10.1177/21925682211063854 · Published: January 1, 2022

Neurology Spinal Disorders Rehabilitation

Simple Explanation

Degenerative Cervical Myelopathy (DCM) is a condition where age-related changes injure the cervical spinal cord. The prevalence of DCM is about 2.3% and is expected to increase with the aging global population. Effective monitoring of DCM is crucial, especially in patients with mild myelopathy or those with spinal cord compression but without myelopathy symptoms. These patients may remain stable, progress slowly, or deteriorate rapidly. An ideal assessment tool for DCM should have validity (measures what it’s supposed to), reliability (consistent measurements), and responsiveness to change (detects subtle changes). It should also be inexpensive, accessible, and easy to administer.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Narrative Review

Key Findings

1
Effective surveillance of the DCM population requires a monitoring framework and the development of new assessment tools, given the increasing prevalence of DCM.
2
No single assessment tool is currently recommended for use in a clinical setting for DCM, highlighting a need for further research and standardization.
3
Implementing effective surveillance involves increasing awareness among primary care practitioners, motivating patient participation, and developing streamlined referral pathways.

Research Summary

This review addresses the critical need for improved assessment and monitoring strategies in Degenerative Cervical Myelopathy (DCM), emphasizing the importance of identifying appropriate assessment tools to evaluate functional impairment, disability, and quality of life in individuals with DCM. The study highlights the limitations of current assessment tools, noting that none are currently recommended for clinical use, and underscores the necessity for developing new, reliable, and responsive measures to effectively monitor disease progression and treatment outcomes. The authors advocate for a multi-faceted approach involving increased awareness among healthcare providers, patient engagement, and streamlined referral pathways to facilitate timely and appropriate management of DCM, including the potential use of smartphone technology for remote monitoring.

Practical Implications

Standardized Assessment

Implementation of standardized assessment protocols can improve the accuracy and consistency of DCM diagnosis and monitoring across different healthcare settings.

Improved Patient Care

Early detection and monitoring of DCM progression can lead to more timely interventions, potentially improving patient outcomes and quality of life.

Research Advancement

The development of new assessment tools and monitoring frameworks can enhance the efficiency and effectiveness of clinical trials and research efforts in DCM.

Study Limitations

1
Lack of standardized assessment tools.
2
Heterogeneity of outcome measures used across studies.
3
Limited high-quality evidence on the psychometric properties of existing tools.

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