Developing Peri-Operative Rehabilitation in Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 6]: An Unexplored Opportunity?
Global Spine Journal
Original Item ID
Degenerative cervical myelopathy is one of the most frequent impairments of the spinal cord encountered internationally in adults. Currently, surgical decompression is the recommended treatment for people with DCM (PwCM) presenting with moderate to severe symptoms or neurological deficits. However, despite surgical intervention, not all patients make a complete recovery due to the irreversible tissue damage within the spinal cord. The objective of this review is to describe the state and gaps in the current literature on rehabilitation for PwCM and possible innovative rehabilitation strategies.
In other neurological disorders such as stroke and acute traumatic spinal cord injury (SCI), timely and strategic rehabilitation has been shown to be indispensable for maximizing functional outcomes, and it is imperative that appropriate perioperative rehabilitative interventions accompany surgical approaches in order to enable the best outcomes. In this review, the current state of knowledge regarding rehabilitation for PwCM is described. Additionally, various therapies that have shown to improve outcomes in comparable neurological conditions such as stroke and SCI which may be translated to DCM will be reviewed.
We conclude that locomotor training and arm/hand therapy may benefit PwCM. Further, we conclude that body weight support, robotic assistance, and virtual/augmented reality therapies may be beneficial therapeutic analogs to locomotor and hand therapies.
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Boerger, Timothy F.; Hyngstrom, Allison S.; Furlan, Julio C.; Klasi-Ryan, Sukhvinder; Curt, Armin; Kwon, Brian K.; Kurpad, Shekar N.; Fehlings, Michael G.; Harrop, James S.; Aarabi, Bizhan; Rahimi-Movaghar, Vafa; Guest, James D.; Wilson, Jefferson R.; Davies, Benjamin M.; Kotter, Mark R. N.; and Koljonen, Paul A., "Developing Peri-Operative Rehabilitation in Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 6]: An Unexplored Opportunity?" (2022). Physical Therapy Faculty Research and Publications. 205.
ADA Accessible Version
Published version. Global Spine Journal, Vol. 12, No. 1 (February 2022): 97S-108S. DOI. © 2022 The Author(s) and published by SAGE Publications. Used with permission.