Rohil Chauhan |
Auckland Spine Surgery Centre, New Zealand
|
Recognising The Silent Squeeze: Early And Evidence-Based Diagnosis Of Cervical Myelopathy In At-Risk Populations
Background: Degenerative cervical myelopathy (DCM) is a progressive disorder of the spinal cord that is susceptible to both missed and delayed diagnoses, leading to unpredictable, progressive and irreversible neurofunctional decline. Early identification of this condition is critical, yet diagnostic delays remain common due to its often-subtle presentation. Recently, the AO Spine Foundation's global research initiative has identified DCM as a top priority, focusing on increasing condition awareness, clarifying its natural history, and refining diagnostic criteria. At our spine centre, we have adopted novel screening methodologies specifically aimed at reducing these diagnostic delays. Through these initiatives, including both clinical and radiological screening, several incidental, yet symptomatic DCM cases have been detected, highlighting the under-recognized prevalence of this condition. Objective: The aim of this presentation is to highlight the critical role of musculoskeletal (MSK) specialists in the early recognition and diagnosis of DCM. Drawing upon clinical audits and recent outputs from the AO Spine DCM working groups, the presentation will explore key findings on screening in at-risk patient populations, diagnostic criteria among Australasian spine surgical specialists, and early-stage diagnostic strategies. Given the role MSK medicine specialists play, in non-emergency, community-based specialist settings, they are well positioned to recognise the early signs of DCM and facilitate timely referral, which could significantly impact patient outcomes. Learning Outcomes:
Conflicts of Interest: The presenter declares no conflicts of interest. Biography Rohil is an Auckland-based physiotherapist, working in an orthopaedic-triage role at the Auckland Spine Surgery Centre and in musculoskeletal private practice at Refine Health Newmarket . He is a Clinical Lecturer at The University of Auckland's Masters of Physiotherapy Practice program and a Clinical Guest Lecturer at AUT's postgraduate Advanced Musculoskeletal Physiotherapy program. He has a research interest in Degenerative Cervical Myelopathy (DCM) and is an invited member of three international DCM working groups focused on perioperative management, professional education, and diagnostic criteria. The latter aims to develop expert consensus and standardize diagnostic criteria to ensure timely recognition and diagnostic workup of DCM. Rohil's current PhD research is aimed at improving the clinical recognition and early diagnosis of DCM in primary and secondary care settings across Australasia. |