Targeting earlier diagnosis: What symptoms come first in Degenerative Cervical Myelopathy?
<h4>Background</h4>Degenerative cervical myelopathy (DCM) is a common and disabling condition. Early effective treatment is limited by late diagnosis. Conventional descriptions of DCM focus on motor and sensory limb disability, however, recent work suggests the true impact is much broade...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0281856 |
| _version_ | 1797843081626648576 |
|---|---|
| author | Colin F Munro Ratko Yurac Zipser Carl Moritz Michael G Fehlings Ricardo Rodrigues-Pinto James Milligan Konstantinos Margetis Mark R N Kotter Benjamin M Davies |
| author_facet | Colin F Munro Ratko Yurac Zipser Carl Moritz Michael G Fehlings Ricardo Rodrigues-Pinto James Milligan Konstantinos Margetis Mark R N Kotter Benjamin M Davies |
| author_sort | Colin F Munro |
| collection | DOAJ |
| description | <h4>Background</h4>Degenerative cervical myelopathy (DCM) is a common and disabling condition. Early effective treatment is limited by late diagnosis. Conventional descriptions of DCM focus on motor and sensory limb disability, however, recent work suggests the true impact is much broader. This study aimed to characterise the symptomatic presentation of DCM from the perspective of people with DCM and determine whether any of the reported symptoms, or groups of symptoms, were associated with early diagnosis.<h4>Methods</h4>An internet survey was developed, using an established list of patient-reported effects. Participants (N = 171) were recruited from an online community of people with DCM. Respondents selected their current symptoms and primary presenting symptom. The relationship of symptoms and their relationship to time to diagnosis were explored. This included symptoms not commonly measured today, termed 'non-conventional' symptoms.<h4>Results</h4>All listed symptoms were experienced by >10% of respondents, with poor balance being the most commonly reported (84.2%). Non-conventional symptoms accounted for 39.7% of symptomatic burden. 55.4% of the symptoms were reported as an initial symptom, with neck pain the most common (13.5%). Non-conventional symptoms accounted for 11.1% of initial symptoms. 79.5% of the respondents were diagnosed late (>6 months). Heavy legs was the only initial symptom associated with early diagnosis.<h4>Conclusions</h4>A comprehensive description of the self-reported effects of DCM has been established, including the prevalence of symptoms at disease presentation. The experience of DCM is broader than suggested by conventional descriptions and further exploration of non-conventional symptoms may support earlier diagnosis. |
| first_indexed | 2024-04-09T16:58:43Z |
| format | Article |
| id | doaj.art-f7f182f59f3a40bc83f93ffb570c60c4 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-09T16:58:43Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-f7f182f59f3a40bc83f93ffb570c60c42023-04-21T05:34:07ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01183e028185610.1371/journal.pone.0281856Targeting earlier diagnosis: What symptoms come first in Degenerative Cervical Myelopathy?Colin F MunroRatko YuracZipser Carl MoritzMichael G FehlingsRicardo Rodrigues-PintoJames MilliganKonstantinos MargetisMark R N KotterBenjamin M Davies<h4>Background</h4>Degenerative cervical myelopathy (DCM) is a common and disabling condition. Early effective treatment is limited by late diagnosis. Conventional descriptions of DCM focus on motor and sensory limb disability, however, recent work suggests the true impact is much broader. This study aimed to characterise the symptomatic presentation of DCM from the perspective of people with DCM and determine whether any of the reported symptoms, or groups of symptoms, were associated with early diagnosis.<h4>Methods</h4>An internet survey was developed, using an established list of patient-reported effects. Participants (N = 171) were recruited from an online community of people with DCM. Respondents selected their current symptoms and primary presenting symptom. The relationship of symptoms and their relationship to time to diagnosis were explored. This included symptoms not commonly measured today, termed 'non-conventional' symptoms.<h4>Results</h4>All listed symptoms were experienced by >10% of respondents, with poor balance being the most commonly reported (84.2%). Non-conventional symptoms accounted for 39.7% of symptomatic burden. 55.4% of the symptoms were reported as an initial symptom, with neck pain the most common (13.5%). Non-conventional symptoms accounted for 11.1% of initial symptoms. 79.5% of the respondents were diagnosed late (>6 months). Heavy legs was the only initial symptom associated with early diagnosis.<h4>Conclusions</h4>A comprehensive description of the self-reported effects of DCM has been established, including the prevalence of symptoms at disease presentation. The experience of DCM is broader than suggested by conventional descriptions and further exploration of non-conventional symptoms may support earlier diagnosis.https://doi.org/10.1371/journal.pone.0281856 |
| spellingShingle | Colin F Munro Ratko Yurac Zipser Carl Moritz Michael G Fehlings Ricardo Rodrigues-Pinto James Milligan Konstantinos Margetis Mark R N Kotter Benjamin M Davies Targeting earlier diagnosis: What symptoms come first in Degenerative Cervical Myelopathy? PLoS ONE |
| title | Targeting earlier diagnosis: What symptoms come first in Degenerative Cervical Myelopathy? |
| title_full | Targeting earlier diagnosis: What symptoms come first in Degenerative Cervical Myelopathy? |
| title_fullStr | Targeting earlier diagnosis: What symptoms come first in Degenerative Cervical Myelopathy? |
| title_full_unstemmed | Targeting earlier diagnosis: What symptoms come first in Degenerative Cervical Myelopathy? |
| title_short | Targeting earlier diagnosis: What symptoms come first in Degenerative Cervical Myelopathy? |
| title_sort | targeting earlier diagnosis what symptoms come first in degenerative cervical myelopathy |
| url | https://doi.org/10.1371/journal.pone.0281856 |
| work_keys_str_mv | AT colinfmunro targetingearlierdiagnosiswhatsymptomscomefirstindegenerativecervicalmyelopathy AT ratkoyurac targetingearlierdiagnosiswhatsymptomscomefirstindegenerativecervicalmyelopathy AT zipsercarlmoritz targetingearlierdiagnosiswhatsymptomscomefirstindegenerativecervicalmyelopathy AT michaelgfehlings targetingearlierdiagnosiswhatsymptomscomefirstindegenerativecervicalmyelopathy AT ricardorodriguespinto targetingearlierdiagnosiswhatsymptomscomefirstindegenerativecervicalmyelopathy AT jamesmilligan targetingearlierdiagnosiswhatsymptomscomefirstindegenerativecervicalmyelopathy AT konstantinosmargetis targetingearlierdiagnosiswhatsymptomscomefirstindegenerativecervicalmyelopathy AT markrnkotter targetingearlierdiagnosiswhatsymptomscomefirstindegenerativecervicalmyelopathy AT benjaminmdavies targetingearlierdiagnosiswhatsymptomscomefirstindegenerativecervicalmyelopathy |