A Systematic Review of Current Terminology for Conditions Preceding Degenerative Cervical Myelopathy: Evidence Synthesis to Inform an AO Spine Expert Opinion Statement
Year: 2025
Type: review
Study design: Systematic Review
Abstract: Study Design Systematic review. Objectives The pre-symptomatic state of Degenerative Cervical Myelopathy (DCM), wherein degenerative changes and spinal cord compression are seen without clinical findings, is poorly understood and inconsistently categorised. Clear identification may elucidate the temporality of DCM development. Therefore, a systematic assessment was undertaken of current terminology for pre-DCM states, with the objective of standardising definitions and informing an AO Spine expert position statement. Methods Medline and Embase were searched for all studies on asymptomatic spinal compression or clinical findings preceding DCM, returning 3585 studies. After screening, 96 studies were included in the final analysis. The terminology used for pre-DCM states and their definitions were extracted, along with their frequencies or speciality/country of author in the literature. Results Multiple terms were used to represent pre-DCM stages, including “ asymptomatic ” (86 studies), “ non-myelopathic ” (26 studies), “without myelopathy” (15 studies), “ pre-symptomatic ” (9 studies) and “ sub-clinical ” (7 studies). “ asymptomatic ” was associated with the greatest inconsistency. Some defined this as patients with radiological signs of spinal degeneration with/without spinal cord compression but no clinical signs of myelopathy, whereas others used the term synonymously with healthy controls. This inconsistency is particularly challenging in clinical studies in which DCM patients are compared to those with pre-DCM states and/or healthy volunteers. Conclusion There is substantial inconsistency in the terms used to describe pre-DCM states. There is no clear relationship between the terms used and the country or speciality of the main author. Standardised definitions for these disease states should be agreed and used in future studies.
Source: Global Spine Journal
Authors: Vinisha Agrawal, Mohammed Farhan Ali, Froher Yasin, Daniyal Ashraf, Jamie F. M. Brannigan, Ratko Yurac, Vishal Kumar, Rory Murphy, Enrico Tessitore, Granit Molliqaj, Joost Dejaegher, Juan José Zamorano, Guy Wynne-Jones, Manjul Tripathi, David B. Anderson, Jose Joefrey F. Arbatin, So Kato, Ronie Romelean Jayapalan, Nicolas Dea, James S. Harrop, Jefferson Wilson, Brian K. Kwon, Allan R. Martin, Josef Bednarik, Mark R. Kotter, Benjamin M. Davies, Oliver D. Mowforth, Aria Nouri
Institutions: University of Cambridge, Universidad del Desarrollo, Clínica Alemana, Post Graduate Institute of Medical Education and Research, Barrow Neurological Institute, University of Geneva, University Hospital of Geneva, KU Leuven, Hospital del Trabajador, Newcastle upon Tyne Hospitals NHS Foundation Trust, The University of Sydney, Chong Hua Hospital, University of Tokyo Hospital, University Malaya Medical Centre, University of British Columbia, Vancouver General Hospital, Thomas Jefferson University, University of Toronto, University of California, Davis, Masaryk University, University Hospital Brno
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,650
Award: G3441721023
OpenAlex ID: W4409983004