Screening for Degenerative Cervical Myelopathy (SCREEN-DCM) in patients based on signs, symptoms and known risk factors – preliminary results

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Objective: Degenerative Cervical Myelopathy (DCM) is the most common cause of spinal cord impairment. Unfortunately, DCM remains poorly recognized and underdiagnosed. To better identify these patients, a screening test for individuals at high risk of DCM, focusing on lumbar degenerative disease (LDD), was developed and undertaken at multiple centers in an effort to uncover a diagnosis of DCM. 

Materials/Methods: A screening test based on signs/symptoms and risk factors of DCM was designed and performed in neurosurgical consultations. A survey of 13 neurosurgeons was used to develop screening criteria for undertaking a cervical MRI. Points are attributed based upon signs/symptoms and comorbidities that predispose or are associated with DCM (e.g. carpal tunnel). Patients with ³3 points undergo a cervical MRI. Patients with positive MRIs are consulted, and management is based on practice guidelines. An exploratory multivariate analysis of the effectiveness and efficiency will be evaluated after positively screening 50 patients. 

Results: Out of 130 patients, 41 screened positive and 30 had a subsequent MRI. Of the 30, 11 (36.7%) were diagnosed with DCM (9/11 presented with T2 hyperintensity), and 3 (10%) were operated. The average number of points for patients screening positive with a diagnosis of myelopathy was 4.71 vs 3.75. All patients with myelopathy were considered as mildly myelopathic. Additionally, 7 of the 30 patients presented with mild stenosis without clear radiological evidence.

Conclusion: Screening for DCM in patients with lumbar pathology is effective for uncovering cervical myelopathy. These are preliminary results and a complete and more extensive analysis from this multicenter study are expected later this year.