A New Framework for Investigating the Biological Basis of Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 5]: Mechanical Stress, Vulnerability and Time.
Publication/Presentation Date
2-1-2022
Abstract
STUDY DESIGN: Literature Review (Narrative).
OBJECTIVE: To propose a new framework, to support the investigation and understanding of the pathobiology of DCM, AO Spine RECODE-DCM research priority number 5.
METHODS: Degenerative cervical myelopathy is a common and disabling spinal cord disorder. In this perspective, we review key knowledge gaps between the clinical phenotype and our biological models. We then propose a reappraisal of the key driving forces behind DCM and an individual's susceptibility, including the proposal of a new framework.
RESULTS: Present pathobiological and mechanistic knowledge does not adequately explain the disease phenotype; why only a subset of patients with visualized cord compression show clinical myelopathy, and the amount of cord compression only weakly correlates with disability. We propose that DCM is better represented as a function of several interacting mechanical forces, such as shear, tension and compression, alongside an individual's vulnerability to spinal cord injury, influenced by factors such as age, genetics, their cardiovascular, gastrointestinal and nervous system status, and time.
CONCLUSION: Understanding the disease pathobiology is a fundamental research priority. We believe a framework of mechanical stress, vulnerability, and time may better represent the disease as a whole. Whilst this remains theoretical, we hope that at the very least it will inspire new avenues of research that better encapsulate the full spectrum of disease.
Volume
12
Issue
1_suppl
First Page
78
Last Page
78
ISSN
2192-5682
Published In/Presented At
Davies, B. M., Mowforth, O., Gharooni, A. A., Tetreault, L., Nouri, A., Dhillon, R. S., Bednarik, J., Martin, A. R., Young, A., Takahashi, H., Boerger, T. F., Newcombe, V. F., Zipser, C. M., Freund, P., Koljonen, P. A., Rodrigues-Pinto, R., Rahimi-Movaghar, V., Wilson, J. R., Kurpad, S. N., Fehlings, M. G., … Kotter, M. R. N. (2022). A New Framework for Investigating the Biological Basis of Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 5]: Mechanical Stress, Vulnerability and Time. Global spine journal, 12(1_suppl), 78S–96S. https://doi.org/10.1177/21925682211057546
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
35174728
Department(s)
Administration and Leadership
Document Type
Article