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

Spinal Cord, 2024 · DOI: 10.1038/s41393-023-00945-8 · Published: December 21, 2023

Simple Explanation

This study investigates how doctors currently manage mild degenerative cervical myelopathy (DCM) and asymptomatic spinal cord compression (ASCC). DCM is a condition where the spinal cord is compressed due to age-related changes in the neck. The researchers surveyed spinal surgeons and other health professionals worldwide to understand their approaches to assessing and treating these conditions. The survey found a lack of consensus among professionals regarding the best practices for managing mild DCM and ASCC, highlighting the need for further research to establish clear guidelines.

Study Duration

From 12th October 2021 to July 7th 2022

Participants

699 spinal surgeons and health professionals

Evidence Level

Cross-sectional survey

Key Findings

1
There is significant variability in the definition and management of mild DCM among professionals.
2
A standardized follow-up for non-operative patients with mild DCM was reported by 69.5% of respondents, but the content of this follow-up varied widely.
3
Practices for ASCC closely aligned with those for mild DCM, suggesting similar inconsistencies in management.

Research Summary

The study assessed current practices in the management of mild degenerative cervical myelopathy (DCM) and asymptomatic spinal cord compression (ASCC) through a web-based survey of spinal surgeons and health professionals. Results revealed a lack of consensus on the definition of mild DCM and the approaches to follow-up and management of both mild DCM and ASCC. The findings highlight the need for further research to define best practices and support patient care for these conditions.

Practical Implications

Develop Standardized Guidelines

The lack of consensus indicates a need for standardized guidelines for the management of mild DCM and ASCC to ensure consistent and effective patient care.

Improve Diagnostic Terminology

Inconsistent use of diagnostic terms can lead to ambiguity; therefore, establishing consistent terminology is crucial for clear communication and effective research.

Enhance Clinician Education

Given the variability in practice, there is a need to improve clinician education regarding the assessment and management of mild DCM and ASCC, emphasizing the use of valid outcome measures.

Study Limitations

1
Potential underrepresentation of certain geographical groups in the survey responses.
2
Reliance on clinician recollection of practice, making it vulnerable to recall bias.
3
The survey used a clinician’s recollection of practice, making it vulnerable to recall bias

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