Jamie F. M. Brannigan, Benjamin M. Davies, Oliver D. Mowforth, Ratko Yurac, Vishal Kumar, Joost Dejaegher, Juan J. Zamorano, Rory K. J. Murphy, Manjul Tripathi, David B. Anderson, James Harrop, Granit Molliqaj, Guy Wynne-Jones, Jose Joefrey F. Arbatin, So Kato, Manabu Ito, Jefferson Wilson, Ronie Romelean, Nicolas Dea, Daniel Graves, Enrico Tessitore, Allan R. Martin, Aria Nouri
{"title":"轻度退行性颈椎病和无症状脊髓压迫症的治疗:一项国际调查","authors":"Jamie F. M. Brannigan, Benjamin M. Davies, Oliver D. Mowforth, Ratko Yurac, Vishal Kumar, Joost Dejaegher, Juan J. Zamorano, Rory K. J. Murphy, Manjul Tripathi, David B. Anderson, James Harrop, Granit Molliqaj, Guy Wynne-Jones, Jose Joefrey F. Arbatin, So Kato, Manabu Ito, Jefferson Wilson, Ronie Romelean, Nicolas Dea, Daniel Graves, Enrico Tessitore, Allan R. Martin, Aria Nouri","doi":"10.1038/s41393-023-00945-8","DOIUrl":null,"url":null,"abstract":"Cross-sectional survey. 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. 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. 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. 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.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-023-00945-8.pdf","citationCount":"0","resultStr":"{\"title\":\"Management of mild degenerative cervical myelopathy and asymptomatic spinal cord compression: an international survey\",\"authors\":\"Jamie F. M. Brannigan, Benjamin M. Davies, Oliver D. Mowforth, Ratko Yurac, Vishal Kumar, Joost Dejaegher, Juan J. Zamorano, Rory K. J. Murphy, Manjul Tripathi, David B. Anderson, James Harrop, Granit Molliqaj, Guy Wynne-Jones, Jose Joefrey F. Arbatin, So Kato, Manabu Ito, Jefferson Wilson, Ronie Romelean, Nicolas Dea, Daniel Graves, Enrico Tessitore, Allan R. Martin, Aria Nouri\",\"doi\":\"10.1038/s41393-023-00945-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Cross-sectional survey. 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. 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. 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. 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Management of mild degenerative cervical myelopathy and asymptomatic spinal cord compression: an international survey
Cross-sectional survey. 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. 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. 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. 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.
期刊介绍:
Spinal Cord is a specialised, international journal that has been publishing spinal cord related manuscripts since 1963. It appears monthly, online and in print, and accepts contributions on spinal cord anatomy, physiology, management of injury and disease, and the quality of life and life circumstances of people with a spinal cord injury. Spinal Cord is multi-disciplinary and publishes contributions across the entire spectrum of research ranging from basic science to applied clinical research. It focuses on high quality original research, systematic reviews and narrative reviews.
Spinal Cord''s sister journal Spinal Cord Series and Cases: Clinical Management in Spinal Cord Disorders publishes high quality case reports, small case series, pilot and retrospective studies perspectives, Pulse survey articles, Point-couterpoint articles, correspondences and book reviews. It specialises in material that addresses all aspects of life for persons with spinal cord injuries or disorders. For more information, please see the aims and scope of Spinal Cord Series and Cases.