The top ten research priorities for DCM published

AO Spine RECODE-DCM meets global burden of DCM

27 May 2020

RECODE-DCM meeting New York 2019
The final consensus meeting took place in New York in November 2019.
Degenerative Cervical Myelopathy (DCM) is the number one cause of spinal cord impairment globally, affecting as many as 2% of adult populations. Despite treatment, less than 5% of people with DCM make a full recovery. Many will have life-long disability and some of the lowest quality of life scores for long-term conditions. To change this and to accelerate urgently required research advances, AO Spine is proud to launch the top ten research priorities for DCM.


The AO Spine Research Objectives and Common Data Elements for DCM (RECODE-DCM) is an international initiative to accelerate knowledge discovery and improve outcomes in DCM. The top ten unanswered research questions for DCM are the first incredible achievement for the initiative. These were gathered and prioritized through a wide consultation and consensus process, set up as a James Lind Alliance Priority Setting Partnership.


The top ten research priorities for DCM

1. Raising awareness

What strategies can increase awareness and understanding of DMC amongst healthcare professionals and the public? Can these strategies help improve timely diagnosis and management of DCM? 

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2. Natural history

What is the natural history of DCM? What is the relationship between DCM and asymptomatic spinal cord compression or canal stenosis? What factors influence the natural history of the disease?

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3. Diagnostic criteria

What are the diagnostic criteria of DCM? What is the role of imaging and when should imaging be used in the assessment of DCM?

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4. Assessment and monitoring

What assessment tools can be used to evaluate functional impairment, disability and quality of life in people with DCM? What instruments, tools or methods can be used or developed to monitor people with DCM for disease progression or improvement either before or after surgical treatment?

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5. Pathophysiology

What is the pathophysiology of DCM? What are the mechanisms of neurological injury and the molecular and anatomical consequences?

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6. Rehabilitation

What is the role of rehabilitation following surgery for DCM? Can structured postoperative rehabilitation improve outcome following surgery for DCM? What are the most effective strategies?

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7. Novel therapies

Can novel therapies, including stem-cell, gene, pharmacological and neuroprotective therapies, improve the health and wellbeing of people living with DCM and slow down disease progression?

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8. Socio-economic impact

What is the socio-economic impact of DCM? (The financial impact of living with DCM to the individual, their supporters, and society as a whole).

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9. Imaging techniques

What is the role of dynamic or novel imaging techniques and neurophysiology in the assessment of DCM?

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 10. Individualizing surgery

Are there clinical and imaging factors that can help a surgeon select who should undergo surgical decompression in the setting of DCM? At what stage of the disease is surgery the preferred management strategy?

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To find out more or to become an AO Spine RECODE-DCM Ambassador, visit the study website

To subscribe to the RECODE-DCM quarterly newsletter, contact AO Spine Research Project Manager Olesja Hazenbiller on

For earlier coverage on RECODE-DCM, read the newsletter here.

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