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Developing Peri-Operative Rehabilitation in Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 6]: An Unexplored Opportunity? Global Spine J 2022 Feb;12(1_suppl):97S-108S

Date

02/18/2022

Pubmed ID

35174735

Pubmed Central ID

PMC8859699

DOI

10.1177/21925682211050925

Scopus ID

2-s2.0-85125812862 (requires institutional sign-in at Scopus site)   14 Citations

Abstract

STUDY DESIGN: Narrative review.

OBJECTIVE: 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.

METHODS: Literature search.

RESULTS: 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.

CONCLUSIONS: 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.

Author List

Boerger TF, Hyngstrom AS, Furlan JC, Kalsi-Ryan S, Curt A, Kwon BK, Kurpad SN, Fehlings MG, Harrop JS, Aarabi B, Rahimi-Movaghar V, Guest JD, Wilson JR, Davies BM, Kotter MRN, Koljonen PA

Authors

Timothy F. Boerger LAT Postdoctoral Researcher 3 in the Neurosurgery department at Medical College of Wisconsin
Allison Hyngstrom PhD Associate Professor in the Physical Therapy department at Marquette University
Shekar N. Kurpad MD, PhD Sr Associate Dean, Professor in the Neurosurgery department at Medical College of Wisconsin