A New Framework for Investigating the Biological Basis of Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 5]: Mechanical Stress, Vulnerability and Time
| Autor: | Benjamin M. Davies, Oliver Mowforth, Aref-Ali Gharooni, Lindsay Tetreault, Aria Nouri, Rana S. Dhillon, Josef Bednarik, Allan R. Martin, Adam Young, Hitoshi Takahashi, Timothy F. Boerger, Virginia FJ Newcombe, Carl Moritz Zipser, Patrick Freund, Paul Aarne Koljonen, Ricardo Rodrigues-Pinto, Vafa Rahimi-Movaghar, Jefferson R. Wilson, Shekar N Kurpad, Michael G. Fehlings, Brian K. Kwon, James S. Harrop, James D. Guest, Armin Curt, Mark R. N. Kotter |
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| Rok vydání: | 2022 |
| Předmět: |
spondylotic
disc herniation Physical Injury - Accidents and Adverse Effects questionnaire cervical stenosis Neurosciences degeneration ossification posterior longitudinal ligament Neurodegenerative recovery spondylosis disability myelopathy Orthopedics and Sports Medicine Surgery Neurology (clinical) Spinal Cord Injury Traumatic Head and Spine Injury |
| Zdroj: | Global spine journal, vol 12, iss 1_suppl |
| ISSN: | 2192-5682 |
| Popis: | Study Design Literature Review (Narrative) Objective To propose a new framework, to support the investigation and understanding of the pathobiology of DCM, AO Spine RECODE-DCM research priority number 5. Methods Degenerative cervical myelopathy is a common and disabling spinal cord disorder. In this perspective, we review key knowledge gaps between the clinical phenotype and our biological models. We then propose a reappraisal of the key driving forces behind DCM and an individual’s susceptibility, including the proposal of a new framework. Results Present pathobiological and mechanistic knowledge does not adequately explain the disease phenotype; why only a subset of patients with visualized cord compression show clinical myelopathy, and the amount of cord compression only weakly correlates with disability. We propose that DCM is better represented as a function of several interacting mechanical forces, such as shear, tension and compression, alongside an individual’s vulnerability to spinal cord injury, influenced by factors such as age, genetics, their cardiovascular, gastrointestinal and nervous system status, and time. Conclusion Understanding the disease pathobiology is a fundamental research priority. We believe a framework of mechanical stress, vulnerability, and time may better represent the disease as a whole. Whilst this remains theoretical, we hope that at the very least it will inspire new avenues of research that better encapsulate the full spectrum of disease. |
| Databáze: | OpenAIRE |
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