Establishing the Socio-Economic Impact of Degenerative Cervical Myelopathy Is Fundamental to Improving Outcomes [AO Spine RECODE-DCM Research Priority Number 8]

Abstract

Study Design: Literature Review (Narrative). Objective: To contextualize AO Spine RECODE-DCM research priority number 5: 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). Methods: In this review, we introduce the methodology of health-economic investigation, including potential techniques and approaches. We summarize the current health-economic evidence within DCM, so far focused on surgical treatment. We also cover the first national estimate, in partnership with Myelopathy.org from the United Kingdom, of the cost of DCM to society. We then demonstrate the significance of this question to advancing care and outcomes in the field. Results: DCM is a common and often disabling condition, with a significant lack of recognition. While evidence demonstrates the cost-effectives of surgery, even among higher income countries, health inequalities exist. Further the prevalent residual disability in myelopathy, despite treatment affects both the individual and society as a whole. A report from the United Kingdom provides the first cost-estimate to their society; an annual cost of ∼£681.6 million per year, but this is likely a significant underestimate. Conclusion: A clear quantification of the impact of DCM is needed to raise the profile of a common and disabling condition. Current evidence suggests this is likely to be globally substantial.

Prospective Randomized Control Trial to Compare the Role of Injection Cerebrolysin for 10 Days Duration Against Placebo in Operated Cases of Degenerative Cervical Myelopathy

“…This aims to assess the financial impact of living with DCM on the individual, their caregivers and society as a whole. Davies et al 14 estimated the cost of DCM on society in the United Kingdom. They reported that the annual cost of admission and treatment alone amounted to £38,900,000 whereas the annual cost to society was estimated to be as high as £681,600,000.…”

Timing of Recovery After Surgery for Patients With Degenerative Cervical Myelopathy: An Observational Study From the Canadian Spine Outcomes and Research Network

“…Ultimately, disability and socioeconomic cost remain high 10a in DCM, while research investment and activity relatively low. 11a New and practice relevant insights have emerged from a multicentre collaboration.…”

Development of a core measurement set for research in degenerative cervical myelopathy: a study protocol (AO Spine RECODE-DCM CMS)

“…These symptoms commonly include gait dysfunction, imbalance and falls, loss of strength and manual dexterity, and pain. Despite current best practice,6 a minority of patients will make a full recovery and DCM is often associated with lifelong disability, impaired quality of life and significant costs to both the individual and to society 7 8…”

“…So far, AO Spine RECODE-DCM has established the top research priorities and agreed on a single definition and index term 4 8 21–32. It has also agreed on ‘what’ should be measured in DCM research: that is, a minimum data set, which is comprised core data elements (CDE) and a core outcome set (COS).…”