6. PERIOPERATIVE REHABILITATION
What is the role of rehabilitation following surgery for DCM? Can structured postoperative rehabilitation improve outcome following surgery for DCM? What are the most effective strategies? 
The perioperative period encompasses the period prior to surgery (the preoperative timeframe), the period during which surgery is performed (the surgical timeframe), and the period after surgery (the postoperative timeframe).
Despite being the gold standard of care for other neurological diseases (e.g. traumatic spinal cord injury, traumatic brain injury or stroke), the role of rehabilitation in Degenerative Cervical Myelopathy (DCM) is poorly understood. For example, a systematic review in 2018 exploring the role of rehabilitation alongside surgery found no published clinical studies at all , whilst a review in 2017 compared rehabilitation to surgery for only a handful of low-quality studies .
The experience and gains seen in related neurological diseases suggest that advancing this evidence base could have significant benefits for DCM.
How Is Myelopathy.org and RECODE-DCM Working to Address this Priority?
The Perioperative Rehabilitation Incubator
AO Spine provided funding to kickstart a global incubator to establish the world’s first best-practice guidelines for DCM. The incubator is working towards clarity on non-operative management and developing an enhanced recovery pathway for patients prior to, during, and after surgery. A major milestone has been reached with the development and piloting of the first ever global survey of current practice. From these results, we will establish a baseline to enable us to test future interventions. The international multidisciplinary group has reached consensus on the optimum time frames for pre-, peri- and postoperative care interventions, and is now working to establish frameworks for maximally effective care during those timeframes.
Learn More about Research Priority 6 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 Episode 6 of the AO Spine RECODE-DCM podcast series we dive into rehab details, when Dr Benjamin Davies and Dr Michelle Starkey talk with Tim Boerger, Dr Julio Furlan, and Dr Armin Curt. What is the role of rehabilitation in DCM, pre- and post-surgery? Why do so few people with DCM receive rehabilitation after surgery? Could it make a difference?