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A Multicenter Registry-Based Study Across the Spectrum of Degenerative Cervical Myelopathy (DCM-RB)

A Multicenter Registry-Based Study of Degenerative Cervical Myelopathy Across the Full Disease Spectrum Based on a Disease-Specific Registry Platform and Linked Biobank

This is a multicenter, prospective, longitudinal, observational registry-based study of degenerative cervical myelopathy (DCM) across the full disease spectrum, linked to a disease-specific biobank. The study will enroll adults with non-myelopathic degenerative cervical cord compression, including asymptomatic degenerative cervical cord compression with or without radiculopathy, as well as patients with mild, moderate, or severe DCM. The study does not assign treatment or interfere with real-world clinical decision-making. All participants will undergo standardized baseline assessment, scheduled follow-up, and event-driven supplemental data collection. Core data include demographic information, comorbidities, disease characteristics, neurological examination, objective functional tests, patient-reported outcomes, cervical MRI findings, treatment pathway, treatment changes, adverse events, and long-term clinical outcomes. In participating centers, standardized biospecimen collection will be performed to support nested biomarker, immune, imaging, electrophysiological, and traditional Chinese medicine syndrome substudies. The main objective is to establish a standardized multicenter registry platform covering non-myelopathic degenerative cervical cord compression and mild, moderate, and severe DCM; to describe clinical trajectories, imaging evolution, treatment pathways, and long-term outcomes; and to identify factors associated with disease deterioration and functional prognosis.

調査の概要

詳細な説明

Degenerative cervical myelopathy (DCM) is an important cause of chronic spinal cord dysfunction in adults. The disease spectrum includes non-myelopathic degenerative cervical cord compression, which may occur with or without radiculopathy, and clinically established mild, moderate, or severe DCM. Current clinical management and research increasingly require standardized longitudinal data collection across different disease stages, treatment pathways, imaging phenotypes, and functional states.

This study will establish a multicenter, prospective, longitudinal, observational registry based on a disease-specific registry platform and linked biobank. The study itself will not interfere with clinical treatment decisions. Participants will receive routine clinical care under real-world practice, including observation, nonsurgical treatment, surgery, or follow-up after previous cervical spine surgery as clinically indicated.

All enrolled participants will enter the same registry platform and undergo standardized baseline assessment, scheduled follow-up, and event-driven supplemental data collection. The registry will use a two-level data structure consisting of a core dataset and optional extended datasets. The core dataset includes demographic characteristics, comorbidities, disease history, neurological examination, objective functional tests, mJOA, JOA, Nurick grade, Neck Disability Index, SF-36v2, cervical MRI findings, treatment exposure, treatment changes, hospitalization, surgery, readmission, reoperation, adverse events, and major functional events.

Extended datasets may include quantitative MRI, diffusion tensor imaging, T2 mapping, electrophysiology, standardized blood biomarkers, PBMC-based immune profiling, omics assays, optional surgically obtained tissue, and structured traditional Chinese medicine syndrome assessment, depending on center capability, ethical approval, funding, and assay validation. The recommended core MRI protocol includes conventional cervical MRI, DTI, and T2 mapping. The core blood collection protocol includes serum, EDTA plasma, buffy coat, and whole blood for biomarker assays and correction variables.

Scheduled follow-up visits are planned at baseline, 3 months, 6 months, 12 months, 24 months, and 36 months, with extension to 60 months when feasible. Event-driven supplemental data collection will be performed when participants develop new myelopathic signs, clinically meaningful neurological deterioration, treatment escalation, surgery, readmission, reoperation, or other major functional events.

The primary endpoint is a composite endpoint of clinical deterioration or disease progression across the spectrum of degenerative cervical cord compression and DCM. The registry will support natural history research, clinical trajectory analysis, treatment pathway evaluation, biomarker exploration, nested prognostic modeling, and real-world outcome evaluation.

研究の種類

観察的

入学 (推定)

200

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究連絡先のバックアップ

研究場所

    • Beijing Municipality
      • Beijing、Beijing Municipality、中国、100102
        • Wangjing Hospital, China Academy of Chinese Medical Sciences
        • コンタクト:
        • 主任研究者:
          • Liguo Zhu
        • 主任研究者:
          • He Yin

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 大人
  • 高齢者

健康ボランティアの受け入れ

はい

サンプリング方法

非確率サンプル

調査対象母集団

Adults with MRI-confirmed degenerative cervical spinal cord compression caused by degenerative pathology will be enrolled from spine outpatient clinics, inpatient wards, preoperative assessment pathways, postoperative follow-up, and imaging review pathways. The study population includes non-myelopathic degenerative cervical cord compression, with or without radiculopathy, and clinically and radiologically confirmed mild, moderate, or severe degenerative cervical myelopathy. All participants must be able to complete baseline core assessments, provide written informed consent, and participate in longitudinal follow-up.

説明

Inclusion Criteria:

  • Age 18 years or older.
  • Cervical MRI confirms cervical spinal cord compression caused by degenerative pathology, including but not limited to disc protrusion or bulging, osteophyte formation, ligamentum flavum hypertrophy or ossification, ossification of the posterior longitudinal ligament, degenerative cervical canal stenosis, or other degenerative compressive factors.
  • At least one cervical level meets one or more of the following imaging criteria: partial or complete disappearance of the cerebrospinal fluid space around the spinal cord, direct contact between the spinal cord and degenerative compressive structures, focal spinal cord indentation, flattening or deformation, or other recognized imaging manifestations of degenerative cervical cord compression.
  • Meets one of the following clinical phenotypes: non-myelopathic degenerative cervical cord compression, with or without clinical radiculopathy; or clinically and radiologically confirmed mild, moderate, or severe degenerative cervical myelopathy.
  • Able to complete baseline core assessments and willing to participate in longitudinal follow-up.
  • Provides written informed consent. Additional consent may be obtained for specific biospecimen types or nested substudies.

Exclusion Criteria:

  • Cervical spinal cord compression or myelopathy mainly caused by non-degenerative etiologies, such as acute trauma, tumor, infection, inflammatory or demyelinating disease, vascular lesion, obvious congenital malformation, or other non-degenerative spinal cord disease.
  • Presence of a dominant other neurological disease or severe psychiatric or cognitive disorder that, in the investigator's judgment, would clearly interfere with DCM-related neurological functional assessment or make reliable follow-up impossible.
  • Objective inability to complete the core imaging assessment or core follow-up and judged by the investigator to be unsuitable for inclusion in the main registry cohort.
  • Refusal to sign informed consent or explicit refusal of core data collection and follow-up.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

コホートと介入

グループ/コホート
介入・治療
A1: Non-myelopathic Degenerative Cervical Cord Compression Without Radiculopathy
Adults with MRI-confirmed non-myelopathic degenerative cervical cord compression without clinical radiculopathy.
Participants will receive routine clinical care according to real-world clinical decision-making. The study does not assign or mandate surgical or nonsurgical treatment. Clinical data, imaging data, follow-up outcomes, adverse events, and biospecimens will be collected according to the registry protocol.
A2: Non-myelopathic Degenerative Cervical Cord Compression With Radiculopathy
Adults with MRI-confirmed non-myelopathic degenerative cervical cord compression with clinical radiculopathy.
Participants will receive routine clinical care according to real-world clinical decision-making. The study does not assign or mandate surgical or nonsurgical treatment. Clinical data, imaging data, follow-up outcomes, adverse events, and biospecimens will be collected according to the registry protocol.
B1: Mild Degenerative Cervical Myelopathy
Adults with clinically and radiologically confirmed degenerative cervical myelopathy with mild neurological impairment, defined as mJOA score 15-17.
Participants will receive routine clinical care according to real-world clinical decision-making. The study does not assign or mandate surgical or nonsurgical treatment. Clinical data, imaging data, follow-up outcomes, adverse events, and biospecimens will be collected according to the registry protocol.
B2: Moderate Degenerative Cervical Myelopathy
Adults with clinically and radiologically confirmed degenerative cervical myelopathy with moderate neurological impairment, defined as mJOA score 12-14.
Participants will receive routine clinical care according to real-world clinical decision-making. The study does not assign or mandate surgical or nonsurgical treatment. Clinical data, imaging data, follow-up outcomes, adverse events, and biospecimens will be collected according to the registry protocol.
B3: Severe Degenerative Cervical Myelopathy
Adults with clinically and radiologically confirmed degenerative cervical myelopathy with severe neurological impairment, defined as mJOA score 0-11.
Participants will receive routine clinical care according to real-world clinical decision-making. The study does not assign or mandate surgical or nonsurgical treatment. Clinical data, imaging data, follow-up outcomes, adverse events, and biospecimens will be collected according to the registry protocol.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Time to First Composite Clinical Deterioration or Disease Progression Event
時間枠:Baseline to 36 months
This outcome will be reported as the time from baseline to the first occurrence of any component of the predefined composite clinical deterioration or disease progression endpoint. The composite endpoint is considered to have occurred when a participant first experiences one or more of the following events: progression from non-myelopathic degenerative cervical cord compression to clinical degenerative cervical myelopathy, a decrease in mJOA score of at least 2 points from baseline; a new clinically meaningful neurological deficit or definite myelopathic sign; predefined worsening in symptom/function state; treatment escalation due to objective disease progression; new sphincter dysfunction; loss of independent ambulation; or another major functional event adjudicated by investigators. Participants without any component event will be censored at the last available follow-up. The unit of measure is months from baseline to the first composite event.
Baseline to 36 months

二次結果の測定

結果測定
メジャーの説明
時間枠
Time to First Treatment Pathway Conversion
時間枠:Baseline to 36 months
This outcome will be reported as the time from baseline to the first treatment pathway conversion. Treatment pathway conversion is defined as a change from observation or regular follow-up to nonsurgical treatment, from observation or nonsurgical treatment to surgery, or another clinically justified treatment strategy change due to symptom worsening, neurological deterioration, imaging progression, or other objective disease progression. Participants without treatment pathway conversion will be censored at the last available follow-up. The unit of measure is months from baseline to first treatment pathway conversion.
Baseline to 36 months
Time to First Cervical Spine Surgery During Follow-up
時間枠:Baseline to 36 months
This outcome will be reported as the time from baseline to the first cervical spine surgery related to degenerative cervical cord compression or degenerative cervical myelopathy during follow-up. Cervical spine surgery includes cervical decompression, fusion, laminoplasty, or other DCM-related cervical surgical procedures. Participants without cervical spine surgery will be censored at the last available follow-up. The unit of measure is months from baseline to first cervical spine surgery.
Baseline to 36 months
Time to First DCM-related Readmission
時間枠:Baseline to 36 months
This outcome will be reported as the time from baseline to the first readmission related to degenerative cervical myelopathy, degenerative cervical cord compression, postoperative complications, disease recurrence, symptom aggravation, or other cervical spine-related causes. Participants without DCM-related readmission will be censored at the last available follow-up. The unit of measure is months from baseline to first DCM-related readmission.
Baseline to 36 months
Time to First Cervical Spine Reoperation or Additional Cervical Intervention
時間枠:Baseline to 36 months
This outcome will be reported as the time from baseline to the first cervical spine reoperation or additional cervical intervention related to degenerative cervical myelopathy, degenerative cervical cord compression, postoperative complications, disease recurrence, adjacent segment problems, or other cervical spine-related causes. Participants without reoperation or additional cervical intervention will be censored at the last available follow-up. The unit of measure is months from baseline to first reoperation or additional cervical intervention.
Baseline to 36 months
Time to First Composite Major Functional Deterioration Event
時間枠:Baseline to 36 months
This outcome will be reported as the time from baseline to the first occurrence of any component of the predefined composite major functional deterioration endpoint. The composite endpoint is considered to have occurred when a participant first experiences new or obviously worsened sphincter dysfunction, loss of independent ambulation, serious fall-related consequences, marked decline in activities of daily living, or another clinically meaningful major functional deterioration event adjudicated by investigators. Participants without any component event will be censored at the last available follow-up. The unit of measure is months from baseline to first composite major functional deterioration event.
Baseline to 36 months
Percentage of Participants With Serious Adverse Events
時間枠:Baseline to 36 months
This outcome will be reported as the percentage of participants who experience at least one serious adverse event during follow-up. Serious adverse events include events resulting in death, life-threatening events, hospitalization or prolonged hospitalization, persistent or significant disability, or other medically important events. The unit of measure is the percentage of participants.
Baseline to 36 months
Percentage of Surgically Treated Participants With Surgical Adverse Events
時間枠:From surgery to 36 months after baseline
This outcome will be reported as the percentage of surgically treated participants who experience at least one surgical adverse event. Surgical adverse events may be recorded using SAVES-V2 or an equivalent structured adverse event recording tool when feasible. The unit of measure is percentage of surgically treated participants.
From surgery to 36 months after baseline
Percentage of Participants With All-Cause Mortality
時間枠:Baseline to 36 months
This outcome will be reported as the percentage of participants who die from any cause during follow-up. The date of death and main cause of death will be recorded when available. The unit of measure is the percentage of participants.
Baseline to 36 months

その他の成果指標

結果測定
メジャーの説明
時間枠
Change From Baseline in mJOA Score
時間枠:Baseline, 3 months, 6 months, 12 months, 24 months, and 36 months
This outcome will be reported as the change from baseline in the modified Japanese Orthopaedic Association score at each scheduled follow-up visit. The mJOA score is a clinician-administered neurological function scale for degenerative cervical myelopathy. The unit of measure is points on the mJOA scale.
Baseline, 3 months, 6 months, 12 months, 24 months, and 36 months
Change From Baseline in JOA Score
時間枠:Baseline, 3 months, 6 months, 12 months, 24 months, and 36 months
This outcome will be reported as the change from baseline in the Japanese Orthopaedic Association score at each scheduled follow-up visit. The unit of measure is points on the JOA scale.
Baseline, 3 months, 6 months, 12 months, 24 months, and 36 months
Change From Baseline in Nurick Grade
時間枠:Baseline, 3 months, 6 months, 12 months, 24 months, and 36 months
This outcome will be reported as the change from baseline in Nurick grade at each scheduled follow-up visit. The Nurick grade is an ordinal clinician-rated measure of gait-related functional impairment in cervical myelopathy. The unit of measure is grade on the Nurick scale.
Baseline, 3 months, 6 months, 12 months, 24 months, and 36 months
Change From Baseline in Neck Disability Index Score
時間枠:Baseline, 3 months, 6 months, 12 months, 24 months, and 36 months
This outcome will be reported as the change from baseline in the Neck Disability Index score at each scheduled follow-up visit. The Neck Disability Index is a patient-reported questionnaire assessing neck-related disability. The unit of measure is points on the Neck Disability Index scale.
Baseline, 3 months, 6 months, 12 months, 24 months, and 36 months
Change From Baseline in SF-36v2 Physical Component Summary Score
時間枠:Baseline, 3 months, 6 months, 12 months, 24 months, and 36 months
This outcome will be reported as the change from baseline in the SF-36v2 Physical Component Summary score at each scheduled follow-up visit. The SF-36v2 is a patient-reported health-related quality of life questionnaire. The unit of measure is points on the SF-36v2 Physical Component Summary scale.
Baseline, 3 months, 6 months, 12 months, 24 months, and 36 months
Change From Baseline in SF-36v2 Mental Component Summary Score
時間枠:Baseline, 3 months, 6 months, 12 months, 24 months, and 36 months
This outcome will be reported as the change from baseline in the SF-36v2 Mental Component Summary score at each scheduled follow-up visit. The SF-36v2 is a patient-reported health-related quality of life questionnaire. The unit of measure is points on the SF-36v2 Mental Component Summary scale.
Baseline, 3 months, 6 months, 12 months, 24 months, and 36 months
Change From Baseline in 10-Second Grip-and-Release Test Count
時間枠:Baseline, 3 months, 6 months, 12 months, 24 months, and 36 months
This outcome will be reported as the change from baseline in the number of grip-and-release cycles completed within 10 seconds at each scheduled follow-up visit. The 10-second grip-and-release test is an objective hand function test. The unit of measure is the number of cycles.
Baseline, 3 months, 6 months, 12 months, 24 months, and 36 months
Change From Baseline in 10-Meter Walking Speed
時間枠:Baseline, 12 months, 24 months, and 36 months, or according to clinical follow-up availability
This outcome will be reported as the change from baseline in walking speed measured by the 10-meter walking test at each scheduled follow-up visit. The unit of measure is meters per second.
Baseline, 12 months, 24 months, and 36 months, or according to clinical follow-up availability
Change From Baseline in Maximum Spinal Cord Compression
時間枠:Baseline, 6 months, 12 months, 24 months, and 36 months
This outcome will be reported as the change from baseline in maximum spinal cord compression measured on cervical MRI. Maximum spinal cord compression will be assessed using offline quantitative MRI measurement. The unit of measure is percentage.
Baseline, 6 months, 12 months, 24 months, and 36 months
Change From Baseline in Maximum Canal Compromise
時間枠:Baseline, 12 months, 24 months, and 36 months
This outcome will be reported as the change from baseline in maximum canal compromise measured on cervical MRI. Maximum canal compromise will be assessed using offline quantitative MRI measurement. The unit of measure is percentage.
Baseline, 12 months, 24 months, and 36 months
Change From Baseline in Spinal Cord Cross-Sectional Area
時間枠:Baseline, 12 months, 24 months, and 36 months, when available
This outcome will be reported as the change from baseline in spinal cord cross-sectional area measured on cervical MRI at the target compression level. The unit of measure is square millimeters.
Baseline, 12 months, 24 months, and 36 months, when available
Change From Baseline in DTI Fractional Anisotropy
時間枠:Baseline, 12 months, 24 months, and 36 months
This outcome will be reported as the change from baseline in fractional anisotropy measured by cervical spinal cord diffusion tensor imaging at the target level or predefined region of interest. The unit of measure is fractional anisotropy value.
Baseline, 12 months, 24 months, and 36 months
Change From Baseline in T2 Mapping Value
時間枠:Baseline, 12 months, 24 months, and 36 months
This outcome will be reported as the change from baseline in cervical spinal cord T2 mapping value measured at the target level or predefined region of interest. The unit of measure is milliseconds.
Baseline, 12 months, 24 months, and 36 months
Change From Baseline in Plasma Neurofilament Light Chain Concentration
時間枠:Baseline, 6 months, 12 months, 24 months, and 36 months
This outcome will be reported as the change from baseline in plasma neurofilament light chain concentration measured in EDTA plasma. The measurement tool is a blood biomarker assay. The unit of measure is picograms per milliliter.
Baseline, 6 months, 12 months, 24 months, and 36 months
Change From Baseline in Serum Interleukin-6 Concentration
時間枠:Baseline, 6 months, 12 months, 24 months, and 36 months
This outcome will be reported as the change from baseline in serum interleukin-6 concentration measured in serum. The measurement tool is a blood biomarker assay. The unit of measure is picograms per milliliter.
Baseline, 6 months, 12 months, 24 months, and 36 months
Change From Baseline in Plasma Brain-Derived Neurotrophic Factor Concentration
時間枠:Baseline, 6 months, 12 months, 24 months, and 36 months
This outcome will be reported as the change from baseline in plasma brain-derived neurotrophic factor concentration measured in EDTA plasma. The measurement tool is a blood biomarker assay. The unit of measure is picograms per milliliter.
Baseline, 6 months, 12 months, 24 months, and 36 months
Time to First Worsening in Symptom and Functional State Category
時間枠:Baseline to 36 months
This outcome will be reported as the time from baseline to the first worsening in the predefined symptom and functional state category. Symptom and functional state will be classified by investigators using a predefined ordinal state category: S0, imaging compression without definite symptoms or signs; S1, radiculopathy-dominant state; S2, sensory-dominant state; S3, upper-limb motor or hand-function dominant state; S4, lower-limb or gait-dominant state; S5, mixed motor involvement; and S6, sphincter dysfunction or severe functional impairment. "Worsening" is defined as a transition to a higher severity state category. The unit of measure is months from baseline to the first worsening in the state category.
Baseline to 36 months

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

捜査官

  • スタディチェア:Liguo Zhu、Wangjing Hospital, China Academy of Chinese Medical Sciences
  • スタディディレクター:He Yin、Wangjing Hospital, China Academy of Chinese Medical Sciences

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

一般刊行物

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2026年6月1日

一次修了 (推定)

2031年12月31日

研究の完了 (推定)

2031年12月31日

試験登録日

最初に提出

2026年5月30日

QC基準を満たした最初の提出物

2026年6月7日

最初の投稿 (実際)

2026年6月11日

学習記録の更新

投稿された最後の更新 (実際)

2026年6月11日

QC基準を満たした最後の更新が送信されました

2026年6月7日

最終確認日

2026年6月1日

詳しくは

本研究に関する用語

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

未定

IPD プランの説明

The individual participant data sharing plan has not yet been finalized. De-identified data may be made available for ethically approved collaborative research after completion of the main analyses, subject to institutional policies, ethics approval, data use agreements, and applicable regulations. Biospecimen access and transfer will require additional approval according to the biobank governance policy, ethics approval, sample management standard operating procedures, and material transfer agreements.

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米国FDA規制機器製品の研究

いいえ

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