Identifying Risk Factors and Healthcare Utilization Prior to a Diagnosis of Degenerative Cervical Myelopathy in an English Population Study: Preliminary Results

Sources of Funding: This work is funded by the NIHR SPCR Post-doctoral fellowship (C111) and the Open Innovation Platform (OIP/23-24/012). LW has also been supported by the NIHR Exeter BRC and the Bateman Professorial Fellowship. Conflicts of Interest: No conflicts of interest Purpose Degenerative cervical myelopathy (DCM) is the most common cause of atraumatic spinal cord compression. The aim of this study was to identify risk factors and the health care journeys associated with DCM. Methods The Clinical Practice Research Datalink Aurum is a population level database. Patients with incident DCM (between 2013 to 2023), and age, gender and region matched controls, were linked to their hospital outpatient and admitted care records. We explored associations between ethnicity, comorbidities and health care utilization in healthcare records in the five years prior to a DCM diagnosis, using conditional logistic and negative binomial regressions. Results We included 6,077 cases, matched to 13,485 controls. Cases had greater odds of Black Caribbean [OR 2.4 (95%CI 1.71 to 3.32)], or mixed ethnicity [OR 1.7 (95% CI 1.08 to 2.71)]. They were more likely to have lumbar spinal stenosis [OR 18.0 (95% CI 13.04 to 24.85)], peripheral neuropathy [OR 5.5 (95% CI 4.35 to 6.98)], carpal tunnel syndrome [OR 4.9 (95% CI 4.04 to 6.02)], or any other neurological condition [OR 2.7 (95%CI 2.16 to 3.33)] in the five-years prior to diagnosis. Cases had more primary care [adjusted incidence rate ratio (IRR) 1.4 (95% CI 1.42 to 1.47)], musculoskeletal-specific secondary care consultations [adjusted IRR 3.4 (95% CI 3.19 to 3.54)] and hospital admissions in the 5-years prior to diagnosis [adjusted IRR 4.1 (95% CI 3.80 to 4.34)]. Conclusion DCM cases have increased health care utilisation and greater odds of DCM-mimicking diagnoses in the 5-years prior to diagnosis in comparison to their matched controls.