CSM is too important. Many questions need to be answered. Now.
After nearly 100 years, the treatment of CSM is still controversial!
Despite CSM has been known for nearly 100 years many questions remain unanswered. Because our understanding of CSM is limited, the treatment of CSM remains controversial! (also see the linked Cochrane Review report.)
The reasons for our uncertainty include our lack of understanding how CSM develops over time, when to best treat patients for CSM, and when surgery is beneficial.
Newly emerging data confirm that surgery can be very effective. However, it is not possible to predict on an individual basis who will benefit from surgery, or to what extent improvements can be expected. Small scale studies indicate that surgery is most likely to be effective when it is conducted early. However, in some individuals the symptoms remain stable over many years and in these patients the risks of surgery may outweigh the risks of CSM. In others CSM causes a rapid decline of hand function and mobility. In these cases early surgery may be able to prevent disability.
Amongst other important questions, we need to find out
These are important gaps in our knowledge that affect our ability to make good clinical decisions and to provide optimal care. Myelopathy.org needs your support to tackle these important questions!
Regenerative treatments for CSM
From clinical experience surgeons know that some patients respond extremely well to surgery. New large scale studies confirm that on average patients' symptoms improve within the first year after surgical decompression. The time scale by which these improvements occur is consistent with a biological repair process. This notion is also supported by recent laboratory findings, which showed that neural cells are able to form new connections in the spinal cord. In the right circumstances, surgical decompression therefore seems to enable a repair process.
However, neither the damage that occurs in CSM as a result of spinal cord compression, nor the nature of the repair process is well understood.
The rapid advances into the treatment of some forms of cancer or disease such as multiple sclerosis have given us a blueprint of how to go about discovering new treatments.
The first thing we need to systematically investigate is
Myelopathy.org needs your help to advance the science for CSM!
Clinical Research investigates the course of disease by tracking patients over time. It also seeks to establish how to diagnose disease, and how patients respond to various forms of treatment.
Preclinical Research is conducted in laboratories to discover the cellular and molecular mechanisms involved in disease. It is also the first step in the discovery of novel therapies.