The Top 10 Research Priorities for Degenerative Cervical Myelopathy (DCM) were established in November 2019 when AO Spine hosted the inaugural consensus meeting.

The international group comprised people living with DCM, their carers, and also a range of their healthcare professionals (e.g. primary care practitioners, physiotherapists, neurologists and surgeons). Multiple research ideas were distilled down, with equitable input from all participants, to provide a list of the most crucial questions to study in DCM. Through a Priority-Setting Partnership process overseen by the James Lind Alliance, the group ensured that these questions are relevant to the whole community of people affected by DCM – those living with the condition, those caring for them, and those treating them.
Researchers around the world must now step up to the challenge of addressing these questions:

1. Raising Awareness

What strategies can increase awareness and understanding of DCM
amongst healthcare professionals and the public? Can these strategies
help improve the timely diagnosis and management of DCM?

2. Natural History

What is the natural history of DCM? What is the relationship between DCM
and asymptomatic spinal cord compression or canal stenosis?
What factors influence the natural history of the disease?

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?

4. Assessment Monitoring

What assessment tools can be used to evaluate functional impairment, disability, and quality of life in people with DCM? What instruments, tools or methods can be used or developed to monitor people with DCM for disease progression or improvement either before or after surgical treatment?

5. Biological Basis

What is the pathophysiology of DCM? What are the mechanisms of
neurological injury and the molecular and anatomical consequences?

6. Perioperative Rehabilitation

What is the role of rehabilitation following surgery for DCM? Can structured postoperative rehabilitation improve outcomes following surgery for DCM?
What are the most effective strategies?

7. Novel Therapies

Can novel therapies, including stem-cell, gene, pharmacological and neuroprotective therapies, improve the health and wellbeing of
people living with DCM and slow down disease progression?

8. Socioeconomic Impact

What is the socio-economic impact of DCM? What is the financial impact of living with DCM to the individual, their supporters and society as a whole?

9. Imaging and Neurophysiology

What is the role of dynamic or novel imaging techniques
and neurophysiology in the assessment of DCM?

10. Individualising Surgery

Are there clinical and imaging factors that can help a surgeon select who should undergo surgical decompression in the setting of DCM? At what stage of the disease is surgery the preferred management strategy?


None of this would have been possible without the support of AO Spine. We wholeheartedly thank them for kickstarting this important initiative.