Previous surgical exposure as a risk factor for development of symptomatic myelopathy
Degenerative Cervical Myelopathy (DCM) is a common and disabling condition, caused by spinal cord compression from arthritis in the neck. Spinal cord compression in the neck can be identified in 1 in 5 healthy adults, but only 1 in 10 go on to develop DCM. Why some develop DCM and others do not is unknown and unpredictable.
We aim to investigate whether people with DCM were more likely to undergo an operation prior to their diagnosis.
This is a question that has been raised by patient stakeholders, through the DCM charity Myelopathy.org, as many report recent and unrelated surgery prior to their diagnosis.
Unless managed carefully when undergoing an anaesthetic, it is recognised that neck disease can damage the spinal cord for example due to neck positioning or blood pressure management during surgery (which affects blood flow to the spinal cord). For patients with Rheumatoid Arthritis for example, today this triggers careful evaluation before an anaesthetic and can be prevented. For DCM, which may be silent or undiagnosed, this does not currently happen.
Our project, which we expect to last around 12 months, is therefore using the UK BioBank data to assess whether people who have DCM are more likely to have had recent surgery than people who don't have DCM. This will help us understand why people develop DCM symptoms, and what we might be able to do to help.