Malone Ailish, Sofiany Maram, Dawood Ghalia, Wright James, Ryan Rody, Treanor Caroline, Gallagher Conor, Lenehan Warren, Doyle Frank, Bolger Ciaran
School of Physiotherapy, RCSI University of Medicine and Health Sciences, Ireland.
School of Medicine, RCSI University of Medicine and Health Sciences, Ireland.
Brain Spine. 2025 Apr 16;5:104252. doi: 10.1016/j.bas.2025.104252. eCollection 2025.
Degenerative cervical myelopathy (DCM), the commonest cause of spinal cord injury, can lead to progressive disability. Due to overlapping symptoms with other conditions and low awareness among healthcare professionals, many patients experience delayed diagnosis.
What is the typical duration of symptoms of DCM before diagnosis?
We searched multiple databases for primary studies reporting duration of symptoms in people with confirmed diagnosis of DCM. Two independent reviewers screened titles, abstracts, full-text articles, extracted data and appraised study quality. We performed random-effects meta-analyses to pool duration of symptoms to presentation, diagnosis, and intervention.
We identified 78 studies from 18 countries, with 12,450 participants. Time from symptom onset to first clinical presentation (two studies, n = 232 participants) was 3.3 (95 % confidence interval, -0.3-6.8) months. Time from symptom onset to diagnosis (five studies, n = 897) was 15.0 (5.0-25.0) months. In 29 studies (n = 3052) that measured from symptom onset to surgery/pre-operative assessment the duration was 14.5 (12.1-17.0) months. Thirty-seven studies had an undefined endpoint, in which when pooled, duration of symptoms was 15.2 (12.4-18.0) months. Most studies did not define the symptoms at onset, however when onset was defined as first occurrence of myelopathic (upper motor neurone) symptoms (five studies, n = 1006), time to surgery was 10.7 (2.3-18.5) months.
Most people with DCM experience symptoms for more than one year before diagnosis. These data may be useful to inform initiatives to promote early diagnosis. Standardised methodology would improve further research in this area.
退行性颈椎脊髓病（DCM）是脊髓损伤最常见的原因，可导致进行性残疾。由于其症状与其他疾病重叠，且医疗保健专业人员的认识不足，许多患者被延迟诊断。
DCM确诊前症状的典型持续时间是多久？
我们在多个数据库中搜索了关于确诊DCM患者症状持续时间的原始研究。两名独立评审员筛选标题、摘要、全文文章，提取数据并评估研究质量。我们进行随机效应荟萃分析，汇总症状出现、诊断和干预的持续时间。
我们从18个国家识别出78项研究，共12450名参与者。从症状出现到首次临床就诊的时间（两项研究，n = 232名参与者）为3.3（95%置信区间，-0.3 - 6.8）个月。从症状出现到诊断的时间（五项研究，n = 897）为15.0（5.0 - 25.0）个月。在29项从症状出现到手术/术前评估进行测量的研究（n = 3052）中，持续时间为14.5（12.1 - 17.0）个月。37项研究的终点不明确，汇总后症状持续时间为15.2（12.4 - 18.0）个月。大多数研究未定义症状出现时的情况，然而，当将症状出现定义为脊髓病（上运动神经元）症状首次出现时（五项研究，n = 1006），到手术的时间为10.7（2.3 - 18.5）个月。
大多数DCM患者在诊断前症状持续超过一年。这些数据可能有助于为促进早期诊断的举措提供信息。标准化方法将改善该领域的进一步研究。
