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



Rodriguespinto R1, 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
Authors
  1. Rodriguespinto R1, 2
  2. Montenegro TS3
  3. Davies BM4
  4. Kato S5
  5. Kawaguchi Y6
  6. Ito M7
  7. Zileli M8
  8. Kwon BK9
  9. Fehlings MG10
  10. Koljonen PA11
  11. Kurpad SN12
  12. Guest JD13
  13. Aarabi B14
  14. Rahimimovaghar V15
  15. Wilson JR10
  16. Kotter MRN4
  17. Harrop JS3
Show Affiliations
Authors Affiliations
  1. 1. Spinal Unit (UVM), Department of Orthopaedics, Centro Hospitalar Universitario do Porto - Hospital de Santo Antonio, Porto, Portugal
  2. 2. Instituto de Ciencias Biomedicas Abel Salazar, Porto, Portugal
  3. 3. Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, United States
  4. 4. Department of Neurosurgery, University of Cambridge, United Kingdom
  5. 5. Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan
  6. 6. Department of Orthopaedic Surgery, University of Toyama, Toyama, Japan
  7. 7. Department of Orthopaedic Surgery, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
  8. 8. Neurosurgery Department, Ege University, Izmir, Bornova, Turkey
  9. 9. Vancouver Spine Surgery Institute, Department of Orthopedics, The University of British Columbia, Vancouver, BC, Canada
  10. 10. Division of Neurosurgery, Department of Surgery, University of Toronto, ON, Canada
  11. 11. Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
  12. 12. Department of Neurosurgery, Medical College of Wisconsin, Wauwatosa, WI, United States
  13. 13. Department of Neurosurgery and The Miami Project to Cure Paralysis, The Miller School of Medicine, University of Miami, Miami, FL, United States
  14. 14. Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, United States
  15. 15. Department of Neurosurgery, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Iran

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.
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