3. DIAGNOSTIC CRITERIA
What are the diagnostic criteria of DCM? What is the role of imaging and when should imaging be used in the assessment of DCM? [1]
There are no specific tests for Degenerative Cervical Myelopathy (DCM), in fact it was only recently defined [2]; instead, professionals must integrate symptoms and examination findings with investigations. Currently, there is no systematic way of doing this; i.e. the findings or categories of findings that are required to make a diagnosis are unclear. This is often a problem in neurological disease, and has been resolved in other fields by diagnostic criteria [1].
Creating this evidence is therefore important, not only to ensure consistency in research, but also to help educate professionals and prevent missed or delayed diagnosis.
How Is Myelopathy.org and RECODE-DCM Working to Address this Priority?
The Diagnostic Criteria Incubator
AO Spine provided funding to kickstart a global incubator to establish diagnostic criteria for DCM. The team is working to formulate reliable diagnostic criteria. Recognising that time is spine, we are committed to diagnosing DCM at an early stage of progression, which vastly improves outcomes. The team has extensively reviewed the frequency, sensitivity and specificity of multiple symptoms and signs. These criteria will be distilled down to form the first ever set of diagnostic criteria for the condition, soon to be published globally.
We took some time to speak with neurologist Dr Lindsay Tetreault, from the Diagnostic Criteria Incubator.
Listen to Podcast Episode: S4E2 – Forming Diagnostic Criteria for Myelopathy, with Dr Lindsay Tetreault and RECODE-DCM
The group has also reviewed diagnostic criteria used for other neurological disorders, to understand how imaging is used. Based on this review, they have created a technical framework and made recommendations on how MRI should be used today [2]. It is hoped that, as imaging techniques for DCM improve over time, this may change; but for now MRI can only rule in a diagnosis of DCM.
Learn More about Research Priority 3 on the Myelopathy Matters Podcast
In 2020, AO Spine took over the Myelopathy Matters podcast to tackle the Top 10 Research Priorities for DCM. In this episode, Dr Benjamin Davies and Dr Michelle Starkey talk to Iwan Sadler, who struggled with the progressive symptoms of DCM for a decade with no diagnosis, prompting him to set up his own online support group. Surgeons Dr James Harrop and Dr Brian Kwon discuss the difficulties of diagnosing DCM today and consider some promising avenues for research to facilitate early diagnosis.
Listen to Podcast Episode: AO Spine Research Top 10 – No. 3 – Diagnostic Criteria