Division of Genetics and Development, Krembil Research Institute, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Suite 4WW-449, Toronto, ON, M5T 2S8, Canada.
Division of Neurosurgery and Spine Program, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Acta Neurochir (Wien). 2023 May;165(5):1105-1119. doi: 10.1007/s00701-023-05558-x. Epub 2023 Apr 1.
Degenerative cervical myelopathy (DCM), a recently coined term, encompasses a group of age-related and genetically associated pathologies that affect the cervical spine, including cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament (OPLL). Given the significant contribution of DCM to global disease and disability, there are worldwide efforts to promote research and innovation in this area. An AO Spine effort termed 'RECODE-DCM' was initiated to create an international multistakeholder consensus group, involving patients, caregivers, physicians and researchers, to focus on launching actionable discourse on DCM. In order to improve the management, treatment and results for DCM, the RECODE-DCM consensus group recently identified ten priority areas for translational research. The current article summarizes recent advancements in the field of DCM. We first discuss the comprehensive definition recently refined by the RECODE-DCM group, including steps taken to arrive at this definition and the supporting rationale. We then provide an overview of the recent advancements in our understanding of the pathophysiology of DCM and modalities to clinically assess and diagnose DCM. A focus will be set on advanced imaging techniques that may offer the opportunity to improve characterization and diagnosis of DCM. A summary of treatment modalities, including surgical and nonoperative options, is then provided along with future neuroprotective and neuroregenerative strategies. This review concludes with final remarks pertaining to the genetics involved in DCM and the opportunity to leverage this knowledge toward a personalized medicine approach.
退变性颈椎脊髓病（DCM）是一个最近才出现的术语，它涵盖了一组与年龄相关和遗传相关的影响颈椎的病理学，包括颈椎病性脊髓病和后纵韧带骨化（OPLL）。鉴于 DCM 对全球疾病和残疾的重大贡献，全世界都在努力促进该领域的研究和创新。AO 脊柱发起了一项名为“RECODE-DCM”的努力，旨在创建一个由患者、护理人员、医生和研究人员组成的国际多方利益相关者共识小组，专注于发起针对 DCM 的可行讨论。为了改善 DCM 的管理、治疗和结果，RECODE-DCM 共识小组最近确定了十个转化研究的优先领域。本文总结了 DCM 领域的最新进展。我们首先讨论了 RECODE-DCM 小组最近精炼的全面定义，包括为达成该定义而采取的步骤和支持的基本原理。然后，我们概述了对 DCM 病理生理学的最新认识，以及用于临床评估和诊断 DCM 的方法。重点将放在可能提供改善 DCM 特征和诊断机会的先进成像技术上。然后，我们将总结治疗方法，包括手术和非手术选择，以及未来的神经保护和神经再生策略。最后，本文将讨论与 DCM 相关的遗传学以及利用这些知识制定个体化医学方法的机会。
