Can screening for degenerative cervical myelopathy (SCREEN-DCM) be effectively undertaken based on signs, symptoms and known risk factors? Rationale and research protocol for a prospective, multicentre, observational study
Introduction Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord impairment. Unfortunately, the condition remains poorly recognised and underdiagnosed. To better identify patients, screening tests that target individuals at high risk would be helpful. One group in particul...
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e060689.full |
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| author | Benjamin Davies Mark Kotter Granit Molliqaj Enrico Tessitore Karl Schaller Teresa Somma Aria Nouri Renato Gondar Joseph S Cheng Paolo Cappabianca Alexandre Lavé Gianpaolo Jannelli Allan Martin Justin Virojanapa Carmen L A Vleggeert-Lankamp Valerie ter Wengel Torstein Meling |
| author_facet | Benjamin Davies Mark Kotter Granit Molliqaj Enrico Tessitore Karl Schaller Teresa Somma Aria Nouri Renato Gondar Joseph S Cheng Paolo Cappabianca Alexandre Lavé Gianpaolo Jannelli Allan Martin Justin Virojanapa Carmen L A Vleggeert-Lankamp Valerie ter Wengel Torstein Meling |
| author_sort | Benjamin Davies |
| collection | DOAJ |
| description | Introduction Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord impairment. Unfortunately, the condition remains poorly recognised and underdiagnosed. To better identify patients, screening tests that target individuals at high risk would be helpful. One group in particular known to have a high prevalence of DCM consists of patients with lumbar degenerative disease (LDD), with the combined presentation referred to as tandem stenosis. Given that LDD is one of the most common presentations in neurosurgical practice and primary care, it is the objective of the proposed study to administer a screening test to these patients as well as those with risk factors or symptoms which raise the suspicion of underlying DCM.Methods and analysis A screening test based on clinical signs/symptoms and known risk factors of DCM was designed. Screening will be performed in neurosurgical consultations for patients with LDD or those with any suspicion of myelopathy. Points are attributed based on the presence of signs/symptoms of DCM (eg, Hoffmann sign, hyper-reflexia) and for comorbidities that predispose or are frequently associated with cervical myelopathy (eg, rheumatoid arthritis, carpal tunnel syndrome). Patients with ≥3 points undergo cervical MRI examination. Patients with positive MRIs will be consulted and receive assessment via modified Japanese Orthopedic Association and Neck Disability Index scores, and subsequent clinical management will be based on practice guidelines. An exploratory multivariate analysis of the effectiveness and efficiency of this proposed screening test will be evaluated after positively screening 50 patients for DCM.Ethics and dissemination This study has received research ethics approval from the Swiss Association of Research Ethics Committees (ID: 2020-02785). The results of this study will be disseminated in a journal targeting physicians commonly encountering patients with LDD. |
| format | Article |
| id | doaj-art-b205a5cce57c47f98e31139656d32ada |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-b205a5cce57c47f98e31139656d32ada2025-01-30T15:20:11ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-060689Can screening for degenerative cervical myelopathy (SCREEN-DCM) be effectively undertaken based on signs, symptoms and known risk factors? Rationale and research protocol for a prospective, multicentre, observational studyBenjamin Davies0Mark Kotter1Granit Molliqaj2Enrico Tessitore3Karl Schaller4Teresa Somma5Aria Nouri6Renato Gondar7Joseph S Cheng8Paolo Cappabianca9Alexandre Lavé10Gianpaolo Jannelli11Allan Martin12Justin Virojanapa13Carmen L A Vleggeert-Lankamp14Valerie ter Wengel15Torstein Meling16Department of Clinical Neurosurgery, Cambridge University, Cambridge, UKDivision of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UKDivision of Neurosurgery, Geneva University Hospitals, Geneva, SwitzerlandDivision of Neurosurgery, Geneva University Hospitals, Geneva, SwitzerlandDivision of Neurosurgery, Geneva University Hospitals, Geneva, SwitzerlandDepartment of Neuroscience and Reproductive and Dental Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, ItalyDivision of Neurosurgery, Geneva University Hospitals, Geneva, SwitzerlandDivision of Neurosurgery, Geneva University Hospitals, Geneva, SwitzerlandDepartment of Neurosurgery, University of Cincinnati Academic Health Center, Cincinnati, Ohio, USADepartment of Neuroscience and Reproductive and Dental Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, ItalyDivision of Neurosurgery, Geneva University Hospitals, Geneva, SwitzerlandDivision of Neurosurgery, Geneva University Hospitals, Geneva, SwitzerlandDepartment of Neurological Surgery, University of California Davis, Sacramento, California, USADepartment of Neurosurgery, University of Cincinnati Academic Health Center, Cincinnati, Ohio, USADepartment of Neurosurgery, Leiden University, Leiden, The NetherlandsDepartment of Neurosurgery, Leiden University, Leiden, The NetherlandsDivision of Neurosurgery, Geneva University Hospitals, Geneva, SwitzerlandIntroduction Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord impairment. Unfortunately, the condition remains poorly recognised and underdiagnosed. To better identify patients, screening tests that target individuals at high risk would be helpful. One group in particular known to have a high prevalence of DCM consists of patients with lumbar degenerative disease (LDD), with the combined presentation referred to as tandem stenosis. Given that LDD is one of the most common presentations in neurosurgical practice and primary care, it is the objective of the proposed study to administer a screening test to these patients as well as those with risk factors or symptoms which raise the suspicion of underlying DCM.Methods and analysis A screening test based on clinical signs/symptoms and known risk factors of DCM was designed. Screening will be performed in neurosurgical consultations for patients with LDD or those with any suspicion of myelopathy. Points are attributed based on the presence of signs/symptoms of DCM (eg, Hoffmann sign, hyper-reflexia) and for comorbidities that predispose or are frequently associated with cervical myelopathy (eg, rheumatoid arthritis, carpal tunnel syndrome). Patients with ≥3 points undergo cervical MRI examination. Patients with positive MRIs will be consulted and receive assessment via modified Japanese Orthopedic Association and Neck Disability Index scores, and subsequent clinical management will be based on practice guidelines. An exploratory multivariate analysis of the effectiveness and efficiency of this proposed screening test will be evaluated after positively screening 50 patients for DCM.Ethics and dissemination This study has received research ethics approval from the Swiss Association of Research Ethics Committees (ID: 2020-02785). The results of this study will be disseminated in a journal targeting physicians commonly encountering patients with LDD.https://bmjopen.bmj.com/content/12/7/e060689.full |
| spellingShingle | Benjamin Davies Mark Kotter Granit Molliqaj Enrico Tessitore Karl Schaller Teresa Somma Aria Nouri Renato Gondar Joseph S Cheng Paolo Cappabianca Alexandre Lavé Gianpaolo Jannelli Allan Martin Justin Virojanapa Carmen L A Vleggeert-Lankamp Valerie ter Wengel Torstein Meling Can screening for degenerative cervical myelopathy (SCREEN-DCM) be effectively undertaken based on signs, symptoms and known risk factors? Rationale and research protocol for a prospective, multicentre, observational study BMJ Open |
| title | Can screening for degenerative cervical myelopathy (SCREEN-DCM) be effectively undertaken based on signs, symptoms and known risk factors? Rationale and research protocol for a prospective, multicentre, observational study |
| title_full | Can screening for degenerative cervical myelopathy (SCREEN-DCM) be effectively undertaken based on signs, symptoms and known risk factors? Rationale and research protocol for a prospective, multicentre, observational study |
| title_fullStr | Can screening for degenerative cervical myelopathy (SCREEN-DCM) be effectively undertaken based on signs, symptoms and known risk factors? Rationale and research protocol for a prospective, multicentre, observational study |
| title_full_unstemmed | Can screening for degenerative cervical myelopathy (SCREEN-DCM) be effectively undertaken based on signs, symptoms and known risk factors? Rationale and research protocol for a prospective, multicentre, observational study |
| title_short | Can screening for degenerative cervical myelopathy (SCREEN-DCM) be effectively undertaken based on signs, symptoms and known risk factors? Rationale and research protocol for a prospective, multicentre, observational study |
| title_sort | can screening for degenerative cervical myelopathy screen dcm be effectively undertaken based on signs symptoms and known risk factors rationale and research protocol for a prospective multicentre observational study |
| url | https://bmjopen.bmj.com/content/12/7/e060689.full |
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