Degenerative cervical myelopathy definition

RECODE-DCM (REsearch Objectives and Common Data Elements for Degenerative Cervical Myelopathy) aims to improve efficient use of health care resources within the field of Degenerative Cervical Myelopathy (DCM) by using a multi-stakeholder partnership to define the DCM research priorities, to develop a minimum dataset for DCM clinical studies, and confirm a Degenerative Cervical Myelopathy definition).

This requires a multi-stakeholder partnership and multiple parallel consensus development processes. It will be conducted via 4 phases, adhering to the guidance set out by the COMET (Core Outcomes in Effectiveness Trials) and JLA (James Lind Alliance) initiatives. Phase 1 will consist of preliminary work to inform online Delphi processes (Phase 2) and a consensus meeting (Phase 3). Following the findings of the consensus meeting, a synthesis of relevant measurement instruments will be compiled and assessed as per the COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) criteria, to allow recommendations to be made on how to measure agreed data points. Phase 4 will monitor and promote the use of eventual recommendations.

RECODE-DCM sets out to establish for the first time an index term, minimum dataset, and research priorities together. The aim is to reduce waste of health care resources in the future by using patient priorities to inform the scope of future DCM research activities. The consistent use of a standard dataset in DCM clinical studies, audit, and clinical surveillance will facilitate pooled analysis of future data and, ultimately, a deeper understanding of DCM 1).

Degenerative cervical myelopathy (DCM) has recently been introduced as an umbrella term for a number of degenerative conditions of the spine that result in cervical myelopathy.

While there has been good uptake within the medical literature since its introduction, cervical myelopathy in its various etiologies lacks a recognized ICD (International Classification of Disease) diagnostic code, Medical Subject Heading (MeSH) for MEDLINE, or equivalent grouping index term. Moreover, key search terms are not unique: myelopathy can be caused by a range of other conditions, degenerative pathology of the spine can occur in the absence of DCM, and the surgical treatments can be applied to other spinal conditions. This complicates literature searches and research synthesis

Cervical myelopathy due to cervical spondylosis is a progressive degenerative spine disease.

Develops in almost all patients with ≥ 30 % narrowing of the cross sectional area of the cervical spinal canal.

Degenerative Cervical Myelopathy (DCM) is a cervical cord compressive lesion that occurs as a result of the normal degenerative process of the cervical spine.

Cervical spinal stenosis is a defining feature of cervical spondylotic myelopathy (CSM).

Davies BM, Khan DZ, Mowforth OD, McNair AGK, Gronlund T, Kolias AG, Tetreault L, Starkey ML, Sadler I, Sarewitz E, Houlton D, Carter J, Kalsi-Ryan S, Aarabi B, Kwon BK, Kurpad SN, Harrop J, Wilson JR, Grossman R, Curt A, Fehlings MG, Kotter MRN. RE-CODE DCM (REsearch Objectives and Common Data Elements for Degenerative Cervical Myelopathy): A Consensus Process to Improve Research Efficiency in DCM, Through Establishment of a Standardized Dataset for Clinical Research and the Definition of the Research Priorities. Global Spine J. 2019 May;9(1 Suppl):65S-76S. doi: 10.1177/2192568219832855. Epub 2019 May 8. PubMed PMID: 31157148; PubMed Central PMCID: PMC6512197.
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