An effective screening tool for uncovering degenerative cervical myelopathy: Results of the prospective multicenter SCREEN-DCM study.
6 affiliations
- 1Division of Neurosurgery, Geneva University Hospitals, Switzerland.
- 2Department of Neurological Surgery, University of California, Davis, Sacramento, CA, USA.
- 3Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
- 4Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy.
- 5Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
- 6Department of Neurosurgery, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
Abstract
Degenerative cervical myelopathy (DCM) is a leading cause of spinal cord injury, yet it remains frequently undiagnosed. Earlier identification may help guide patients into appropriate diagnostic and referral pathways before substantial neurological disability has accumulated. This study aimed to evaluate the diagnostic performance of SCREEN-DCM for identifying previously undiagnosed DCM. We conducted a prospective multicenter diagnostic accuracy study, where 200 consecutive adults presenting with lumbar degenerative disease were screened with the SCREEN-DCM clinical score, based on established DCM symptoms, signs, and risk factors. SCREEN-DCM scores ≥3 were considered positive. 69 (34.5%) participants screened positive and 131 (65.5%) screened negative. Cervical MRI was performed in 83 participants. DCM was identified in 29 of 57 screen-positive patients and 1 of 26 screen-negative patients. SCREEN-DCM demonstrated 96.7% sensitivity, 47.2% specificity, 50.9% positive predictive value, 96.2% negative predictive value, and an AUC of 0.87 (95% CI, 0.79-0.95). Approximately two MRIs were required to detect one DCM case among screen-positive patients. Diagnostic sensitivity remained high across exploratory age groups. A simplified eight-variable model showed comparable discrimination (AUC, 0.85; 95% CI, 0.77-0.93), with Hoffman's sign, gait ataxia, and hand clumsiness among the strongest predictors of DCM. SCREEN-DCM has a very high sensitivity to identify DCM in previously undiagnosed patients. By identifying patients who may otherwise experience diagnostic delay, the screening tool could support earlier referral and prevention of avoidable neurological disability.
Related
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- Long-Term Outcomes of Spinous Process Splitting Laminoplasty Using Coralline Hydroxyapatite (SLAC) for Multilevel Degenerative Cervical Myelopathy: A Comparative Study of CSM and OPLL.
- A systematic review of the spectrum of magnetic resonance imaging features of degenerative thoracic myelopathy
BibTeX
@article{nouri2026effective,
title = {{An effective screening tool for uncovering degenerative cervical myelopathy: Results of the prospective multicenter SCREEN-DCM study.}},
author = {Aria Nouri and Nasser Bouhalassa and Simone Grannò and Francesca Brigatti and Granit Molliqaj and Alexandre Lavé and Gianpaolo Jannelli and Allan Martin and Rebecca Garner and Justin Virojanapa and Joseph Cheng and Teresa Somma and Mark Kotter and Carmen Vleggeert-Lankamp and Karl Schaller and Enrico Tessitore},
journal = {Brain \& spine},
year = {2026},
month = oct,
doi = {10.1016/j.bas.2026.107478},
url = {https://europepmc.org/article/MED/42999635},
note = {CC BY},
}
RIS
TY - JOUR
TI - An effective screening tool for uncovering degenerative cervical myelopathy: Results of the prospective multicenter SCREEN-DCM study.
AU - Aria Nouri
AU - Nasser Bouhalassa
AU - Simone Grannò
AU - Francesca Brigatti
AU - Granit Molliqaj
AU - Alexandre Lavé
AU - Gianpaolo Jannelli
AU - Allan Martin
AU - Rebecca Garner
AU - Justin Virojanapa
AU - Joseph Cheng
AU - Teresa Somma
AU - Mark Kotter
AU - Carmen Vleggeert-Lankamp
AU - Karl Schaller
AU - Enrico Tessitore
PY - 2026
DA - 2026/10/16
JO - Brain & spine
DO - 10.1016/j.bas.2026.107478
UR - https://europepmc.org/article/MED/42999635
AB - Degenerative cervical myelopathy (DCM) is a leading cause of spinal cord injury, yet it remains frequently undiagnosed. Earlier identification may help guide patients into appropriate diagnostic and referral pathways before substantial neurological disability has accumulated. This study aimed to evaluate the diagnostic performance of SCREEN-DCM for identifying previously undiagnosed DCM. We conducted a prospective multicenter diagnostic accuracy study, where 200 consecutive adults presenting with lumbar degenerative disease were screened with the SCREEN-DCM clinical score, based on established DCM symptoms, signs, and risk factors. SCREEN-DCM scores ≥3 were considered positive. 69 (34.5%) participants screened positive and 131 (65.5%) screened negative. Cervical MRI was performed in 83 participants. DCM was identified in 29 of 57 screen-positive patients and 1 of 26 screen-negative patients. SCREEN-DCM demonstrated 96.7% sensitivity, 47.2% specificity, 50.9% positive predictive value, 96.2% negative predictive value, and an AUC of 0.87 (95% CI, 0.79-0.95). Approximately two MRIs were required to detect one DCM case among screen-positive patients. Diagnostic sensitivity remained high across exploratory age groups. A simplified eight-variable model showed comparable discrimination (AUC, 0.85; 95% CI, 0.77-0.93), with Hoffman's sign, gait ataxia, and hand clumsiness among the strongest predictors of DCM. SCREEN-DCM has a very high sensitivity to identify DCM in previously undiagnosed patients. By identifying patients who may otherwise experience diagnostic delay, the screening tool could support earlier referral and prevention of avoidable neurological disability.
SN - 2772-5294
ER -