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@article{2251356, author = {Davies, Benjamin M and Mowforth, Oliver and Gharooni, ArefandAli and Tetreault, Lindsay and Nouri, Aria and Dhillon, Rana S and Bednařík, Josef and Martin, Allan R and Young, Adam and Takahashi, Hitoshi and Boerger, Timothy F and Newcombe, Virginia F J and Zipser, Carl Moritz and Freund, Patrick and Koljonen, Paul Aarne and RodriguesandPinto, Ricardo and RahimiandMovaghar, Vafa and Wilson, Jefferson R and Kurpad, Shekar N and Fehlings, Michael G and Kwon, Brian K and Harrop, James S and Guest, James D and Curt, Armin and Kotter, Mark R N}, article_location = {LONDON}, article_number = {1_SUPPL}, doi = {http://dx.doi.org/10.1177/21925682211057546}, keywords = {cervical; myelopathy; spondylosis; spondylotic; stenosis; disc herniation; ossification posterior longitudinal ligament; degeneration; disability; recovery; questionnaire}, language = {eng}, issn = {2192-5682}, journal = {GLOBAL SPINE JOURNAL}, title = {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}, url = {https://journals.sagepub.com/doi/10.1177/21925682211057546}, volume = {12}, year = {2022} }
TY - JOUR ID - 2251356 AU - Davies, Benjamin M - Mowforth, Oliver - Gharooni, Aref-Ali - Tetreault, Lindsay - Nouri, Aria - Dhillon, Rana S - Bednařík, Josef - Martin, Allan R - Young, Adam - Takahashi, Hitoshi - Boerger, Timothy F - Newcombe, Virginia F J - Zipser, Carl Moritz - Freund, Patrick - Koljonen, Paul Aarne - Rodrigues-Pinto, Ricardo - Rahimi-Movaghar, Vafa - Wilson, Jefferson R - Kurpad, Shekar N - Fehlings, Michael G - Kwon, Brian K - Harrop, James S - Guest, James D - Curt, Armin - Kotter, Mark R N PY - 2022 TI - 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 JF - GLOBAL SPINE JOURNAL VL - 12 IS - 1_SUPPL SP - "78S"-"96S" EP - "78S"-"96S" PB - SAGE PUBLICATIONS LTD SN - 21925682 KW - cervical KW - myelopathy KW - spondylosis KW - spondylotic KW - stenosis KW - disc herniation KW - ossification posterior longitudinal ligament KW - degeneration KW - disability KW - recovery KW - questionnaire UR - https://journals.sagepub.com/doi/10.1177/21925682211057546 N2 - 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. ER -
DAVIES, Benjamin M, Oliver MOWFORTH, Aref-Ali GHAROONI, Lindsay TETREAULT, Aria NOURI, Rana S DHILLON, Josef BEDNAŘÍK, Allan R MARTIN, Adam YOUNG, Hitoshi TAKAHASHI, Timothy F BOERGER, Virginia F J 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 a Mark R N KOTTER. 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. \textit{GLOBAL SPINE JOURNAL}. LONDON: SAGE PUBLICATIONS LTD, 2022, roč.~12, 1\_{}SUPPL, s.~''78S''-''96S'', 19 s. ISSN~2192-5682. Dostupné z: https://dx.doi.org/10.1177/21925682211057546.
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