Optimizing the Application of Surgery for Degenerative Cervical Myelopathy [Ao Spine Recode-Dcm Research Priority Number 10] Publisher



Rodriguespinto R^{1, 2} ; Montenegro TS³ ; Davies BM⁴ ; Kato S⁵ ; Kawaguchi Y⁶ ; Ito M⁷ ; Zileli M⁸ ; Kwon BK⁹ ; Fehlings MG¹⁰ ; Koljonen PA¹¹ ; Kurpad SN¹² ; Guest JD¹³ ; Aarabi B¹⁴ ; Rahimimovaghar V¹⁵ Show All Authors
Source: Global Spine Journal Published:2022

Abstract

Study Design: Literature Review (Narrative). Objective: To introduce the number 10 research priority for Degenerative Cervical Myelopathy: Individualizing Surgery. Methods: This article summarizes the current recommendations and indications for surgery, including how known prognostic factors such as injury time, age, disease severity, and associated comorbidities impact surgical outcome. It also considers key areas of uncertainty that should be the focus of future research. Results: While a small proportion of conservatively managed patients may remain stable, the majority will deteriorate over time. To date, surgical decompression is the mainstay of treatment, able to halt disease progression and improve neurologic function and quality of life for most patients. Whilst this recognition has led to recommendations on when to offer surgery, there remain many uncertainties including the type of surgery, or timing in milder and/or asymptomatic cases. Their clarification has the potential to transform outcomes, by ensuring surgery offers each individual its maximum benefit. Conclusion: Developing the evidence to better guide surgical decision-making at the individual patient level is a research priority for Degenerative Cervical Myelopathy. © The Author(s) 2021.