Serologic and Quantitative MRI Biomarkers for Mild Degenerative Cervical Myelopathy: A Step Toward Personalized Medicine
Principle Investigators: Drs Michael Fehlings at Toronto Western Hospital and Jeff Wilson at St. Michaels Hospital in Toronto.
Degenerative cervical myelopathy (DCM) is the leading cause of spinal cord injury. This develops when arthritis of the neck causes compression of the spinal cord and resultant disability. Surgery is the standard of care for moderate or severe DCM. The management of patients with mild DCM is less straightforward. These patients have fewer disabling symptoms, and the risks of surgery may outweigh the benefits. Alternatively, an intervention at this stage could prevent severe, irreversible deficits if the disease were to progress. Patients who are likely to deteriorate neurologically cannot currently be identified.
This study seeks to evaluate whether a genetic marker, namely apolipoprotein E (ApoE), and next-generation MRI may be used to identify patients who are at risk of deterioration if left untreated. The goal is to permit personalized delivery of healthcare based on knowledge of a patient’s unique genetic status and spinal cord imaging.