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Management of mild degenerative cervical myelopathy and asymptomatic spinal cord compression: an international survey.

Published version
Peer-reviewed

Repository DOI


Change log

Authors

Brannigan, Jamie FM  ORCID logo  https://orcid.org/0000-0003-1697-403X
Mowforth, Oliver D 
Yurac, Ratko 
Kumar, Vishal 

Abstract

STUDY DESIGN: Cross-sectional survey. OBJECTIVE: Currently there is limited evidence and guidance on the management of mild degenerative cervical myelopathy (DCM) and asymptomatic spinal cord compression (ASCC). Anecdotal evidence suggest variance in clinical practice. The objectives of this study were to assess current practice and to quantify the variability in clinical practice. METHODS: Spinal surgeons and some additional health professionals completed a web-based survey distributed by email to members of AO Spine and the Cervical Spine Research Society (CSRS) North American Society. Questions captured experience with DCM, frequency of DCM patient encounters, and standard of practice in the assessment of DCM. Further questions assessed the definition and management of mild DCM, and the management of ASCC. RESULTS: A total of 699 respondents, mostly surgeons, completed the survey. Every world region was represented in the responses. Half (50.1%, n = 359) had greater than 10 years of professional experience with DCM. For mild DCM, standardised follow-up for non-operative patients was reported by 488 respondents (69.5%). Follow-up included a heterogeneous mix of investigations, most often at 6-month intervals (32.9%, n = 158). There was some inconsistency regarding which clinical features would cause a surgeon to counsel a patient towards surgery. Practice for ASCC aligned closely with mild DCM. Finally, there were some contradictory definitions of mild DCM provided in the form of free text. CONCLUSIONS: Professionals typically offer outpatient follow up for patients with mild DCM and/or asymptomatic ASCC. However, what this constitutes varies widely. Further research is needed to define best practice and support patient care.

Description

Acknowledgements: This research aligns with the AO Spine RECODE-DCM top research priority Natural History selected by people living and working with DCM. For further information on how this process was conducted, why this question was prioritised, and global updates on currently aligned research, please visit aospine.org/recode/natural history.

Keywords

Humans, Spinal Cord Compression, Cross-Sectional Studies, Magnetic Resonance Imaging, Spinal Cord Injuries, Spinal Cord Diseases, Cervical Vertebrae

Journal Title

Spinal Cord

Conference Name

Journal ISSN

1362-4393
1476-5624

Volume Title

62

Publisher

Springer Science and Business Media LLC
Sponsorship
Department of Health (via National Institute for Health Research (NIHR)) (NIHR300696)
National Institute for Health and Care Research (NIHR300696)