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dc.contributor.authorGharooni, Aref-Ali
dc.contributor.authorKwon, Brian K
dc.contributor.authorFehlings, Michael G
dc.contributor.authorBoerger, Timothy F
dc.contributor.authorRodrigues-Pinto, Ricardo
dc.contributor.authorKoljonen, Paul Aarne
dc.contributor.authorKurpad, Shekar N
dc.contributor.authorHarrop, James S
dc.contributor.authorAarabi, Bizhan
dc.contributor.authorRahimi-Movaghar, Vafa
dc.contributor.authorWilson, Jefferson R
dc.contributor.authorDavies, Benjamin M
dc.contributor.authorKotter, Mark R N
dc.contributor.authorGuest, James D
dc.date.accessioned2022-03-14T13:16:25Z
dc.date.available2022-03-14T13:16:25Z
dc.date.issued2022-02
dc.identifier.urihttp://hdl.handle.net/10713/18230
dc.description.abstractStudy design: Narrative review. Objectives: To provide an overview of contemporary therapies for the James Lind Alliance priority setting partnership for degenerative cervical myelopathy (DCM) question: ‘Can novel therapies, including stem-cell, gene, pharmacological and neuroprotective therapies, be identified to improve the health and wellbeing of people living with DCM and slow down disease progression?’ Methods: A review of the literature was conducted to outline the pathophysiology of DCM and present contemporary therapies that may hold therapeutic value in 3 broad categories of neuroprotection, neuroregeneration, and neuromodulation. Results: Chronic spinal cord compression leads to ischaemia, neuroinflammation, demyelination, and neuronal loss. Surgical intervention may halt progression and improve symptoms, though the majority do not make a full recovery leading to lifelong disability. Neuroprotective agents disrupt deleterious secondary injury pathways, and one agent, Riluzole, has undergone Phase-III investigation in DCM. Although it did not show efficacy on the primary outcome modified Japanese Orthopaedic Association scale, it showed promising results in pain reduction. Regenerative approaches are in the early stage, with one agent, Ibudilast, currently in a phase-III investigation. Neuromodulation approaches aim to therapeutically alter the state of spinal cord excitation by electrical stimulation with a variety of approaches. Case studies using electrical neuromuscular and spinal cord stimulation have shown positive therapeutic utility. Conclusion: There is limited research into interventions in the 3 broad areas of neuroprotection, neuroregeneration, and neuromodulation for DCM. Contemporary and novel therapies for DCM are now a top 10 priority, and whilst research in these areas is limited in DCM, it is hoped that this review will encourage research into this priority. © The Author(s) 2022.en_US
dc.description.urihttps://doi.org/10.1177/21925682211052920en_US
dc.language.isoenen_US
dc.publisherSAGE Publications Inc.en_US
dc.relation.ispartofGlobal Spine Journalen_US
dc.subjectdegenerative cervical myelopathyen_US
dc.subjectdemyelinationen_US
dc.subjectelectrical stimulationen_US
dc.subjectfunctional electrical stimulationen_US
dc.subjectinflammationen_US
dc.subjectneuromodulationen_US
dc.subjectneuromuscular electrical stimulationen_US
dc.subjectneuroprotectionen_US
dc.subjectneuroregenerationen_US
dc.subjectspinal cord stimulationen_US
dc.titleDeveloping Novel Therapies for Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 7]: Opportunities From Restorative Neurobiology.en_US
dc.typeArticleen_US
dc.identifier.doi10.1177/21925682211052920
dc.identifier.pmid35174725
dc.source.journaltitleGlobal spine journal
dc.source.volume12
dc.source.issue1_suppl
dc.source.beginpage109S
dc.source.endpage121S
dc.source.countryEngland


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