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How Is Spinal Cord Function Measured in Degenerative Cervical Myelopathy? A Systematic Review.

作者信息

Soufi Khadija H, Perez Tess M, Umoye Alexis O, Yang Jamie, Burgos Maria, Martin Allan R

机构信息

Department of Neurological Surgery, University of California, Davis, Sacramento, CA 95817, USA.

出版信息

J Clin Med. 2022 Mar 5;11(5):1441. doi: 10.3390/jcm11051441.


DOI:10.3390/jcm11051441
PMID:35268533
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8910882/
Abstract

Degenerative cervical myelopathy (DCM) is a prevalent condition in which spinal degeneration causes cord compression and neurological dysfunction. The spinal cord is anatomically complex and operates in conjunction with the brain, the musculoskeletal system, and numerous organs to control numerous functions, including simple and coordinated movement, sensation, and autonomic functions. As a result, accurate and comprehensive measurement of spinal cord function in patients with DCM and other spinal pathologies is challenging. This project aimed to summarize the neurological, functional, and quality of life (QoL) outcome measures currently in use to quantify impairment in DCM. A systematic review of the literature was performed to identify prospective studies with at least 100 DCM subjects that utilized one or more quantitative neurological, functional, or QoL outcome measures. A total of 148 studies were identified. The most commonly used instruments were subjective functional scales including the Japanese Orthopedic Association (JOA) (71 studies), modified JOA (mJOA) (66 studies), Neck Disability Index (NDI) (54 studies), and Nurick (39 studies), in addition to the QoL measure Short-Form-36 (SF-36, 52 studies). A total of 92% (320/349) of all outcome measures were questionnaires, whereas objective physical testing of neurological function (strength, gait, balance, dexterity, or sensation) made up 8% (29/349). Studies utilized an average of 2.36 outcomes measures, while 58 studies (39%) utilized only a single outcome measure. No studies were identified that specifically assessed the dorsal column sensory pathway or respiratory, bowel, or sexual function. In the past five years, there were no significant differences in the number of total, functional, or QoL outcome measures used, but physical testing of neurological function has increased ( = 0.005). Prior to 2017, cervical spondylotic myelopathy (CSM) was the most frequently used term to describe the study population, whereas in the last five years, DCM has become the preferred terminology. In conclusion, clinical studies of DCM typically utilize limited data to characterize impairment, often relying on subjective, simplistic, and non-specific measures that do not reflect the complexity of the spinal cord. Although accurate measurement of impairment in DCM is challenging, it is necessary for early diagnosis, monitoring for deterioration, and quantifying recovery after therapeutic interventions. Clinical decision-making and future clinical studies in DCM should employ a combination of subjective and objective assessments to capture the multitude of spinal cord functions to improve clinical management and inform practice guidelines.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9744/8910882/18bdfc0ceb96/jcm-11-01441-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9744/8910882/2ad69a9c14da/jcm-11-01441-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9744/8910882/915d922438b1/jcm-11-01441-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9744/8910882/21883502e120/jcm-11-01441-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9744/8910882/18bdfc0ceb96/jcm-11-01441-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9744/8910882/2ad69a9c14da/jcm-11-01441-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9744/8910882/915d922438b1/jcm-11-01441-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9744/8910882/21883502e120/jcm-11-01441-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9744/8910882/18bdfc0ceb96/jcm-11-01441-g004.jpg

相似文献

[1]
How Is Spinal Cord Function Measured in Degenerative Cervical Myelopathy? A Systematic Review.

J Clin Med. 2022-3-5

[2]
Predictive effect of cervical spinal cord compression and corresponding segmental paravertebral muscle degeneration on the severity of symptoms in patients with cervical spondylotic myelopathy.

Spine J. 2021-7

[3]
Ancillary outcome measures for assessment of individuals with cervical spondylotic myelopathy.

Spine (Phila Pa 1976). 2013-10-15

[4]
Characteristics of Upper Limb Impairment Related to Degenerative Cervical Myelopathy: Development of a Sensitive Hand Assessment (Graded Redefined Assessment of Strength, Sensibility, and Prehension Version Myelopathy).

Neurosurgery. 2020-3-1

[5]
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[6]
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[7]
Correlation of quality of life and functional outcome measures for cervical spondylotic myelopathy.

J Neurosurg Spine. 2016-3

[8]
Clinical outcome measures and their evidence base in degenerative cervical myelopathy: a systematic review to inform a core measurement set (AO Spine RECODE-DCM).

BMJ Open. 2022-1-19

[9]
Degenerative cervical myelopathy: establishing severity thresholds for neuromotor dysfunction in the aging spine using the NIH Toolbox Assessment Scale.

Geroscience. 2024-4

[10]
Functional outcome instruments used for cervical spondylotic myelopathy: interscale correlation and prediction of preference-based quality of life.

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引用本文的文献

[1]
Deep learning models for MRI-based clinical decision support in cervical spine degenerative diseases.

Front Neurosci. 2024-12-6

[2]
Scoping Review with Topic Modeling on the Diagnostic Criteria for Degenerative Cervical Myelopathy.

Global Spine J. 2024-9

[3]
Brain MRI changes in degenerative cervical myelopathy: a systematic review.

EBioMedicine. 2024-1

[4]
Degenerative cervical myelopathy: establishing severity thresholds for neuromotor dysfunction in the aging spine using the NIH Toolbox Assessment Scale.

Geroscience. 2024-4

[5]
Predictive Value of Preoperative Short Form-36 Survey Scale for Postoperative Axial Neck Pain in Patients With Degenerative Cervical Myelopathy.

Global Spine J. 2025-3

[6]
Effect of cervical suspensory traction in the treatment of severe cervical kyphotic deformity.

Front Surg. 2023-1-6

[7]
Degenerative Cervical Myelopathy and Spinal Cord Injury: Introduction to the Special Issue.

J Clin Med. 2022-7-22

本文引用的文献

[1]
Imaging and Electrophysiology for Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 9].

Global Spine J. 2022-2

[2]
International Standards to document Autonomic Function following SCI (ISAFSCI): Second Edition.

Top Spinal Cord Inj Rehabil. 2021

[3]
Clinical outcomes of nonoperatively managed degenerative cervical myelopathy: an ambispective longitudinal cohort study in 117 patients.

J Neurosurg Spine. 2021-4-9

[4]
Inter-rater Reliability of the Modified Japanese Orthopedic Association Score in Degenerative Cervical Myelopathy: A Cross-sectional Study.

Spine (Phila Pa 1976). 2021-8-15

[5]
Characteristics of Upper Limb Impairment Related to Degenerative Cervical Myelopathy: Development of a Sensitive Hand Assessment (Graded Redefined Assessment of Strength, Sensibility, and Prehension Version Myelopathy).

Neurosurgery. 2020-3-1

[6]
Monitoring for myelopathic progression with multiparametric quantitative MRI.

PLoS One. 2018-4-17

[7]
A Clinical Practice Guideline for the Management of Patients With Degenerative Cervical Myelopathy: Recommendations for Patients With Mild, Moderate, and Severe Disease and Nonmyelopathic Patients With Evidence of Cord Compression.

Global Spine J. 2017-9

[8]
The Natural History of Degenerative Cervical Myelopathy and the Rate of Hospitalization Following Spinal Cord Injury: An Updated Systematic Review.

Global Spine J. 2017-9

[9]
Reported Outcome Measures in Degenerative Cervical Myelopathy: A Systematic Review.

PLoS One. 2016-8-2

[10]
The modified Japanese Orthopaedic Association scale: establishing criteria for mild, moderate and severe impairment in patients with degenerative cervical myelopathy.

Eur Spine J. 2017-1

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