Poster Presentation Sydney Spinal Symposium 2023

The MYelopathy NAtural History (MYNAH) Registry: Protocol for Australian registry (#35)

Nashwa Najib 1 2 3 , Perminder Sachdev 4 , Sanja Lujic 5 , Nancy Briggs 6 , Alper Yataganbaba 7 , Lauren Barber 3 , Prashanth Rao 8 , Bhisham Singh 7 , Brian Hsu 7 , Ali Ghahreman 9 , Mark Davies 1 2 9 , Michael Johnson 10 , Mitchell Hansen 11 , Saeed Kohan 9 , Ralph Mobbs 12 , Sonia Bustamante 13 , Valerie Wasinger 6 , Alisha Sial 1 2 3 , Neha Chopra 2 , Ashish Diwan 1 2 3
  1. St George and Sutherland Clinical School, Sydney, NSW, Australia
  2. University of New South Wales, Kogarah, NSW, Australia
  3. Spine Labs & Spine Service, Department of Orthopaedic Surgery, Division of Surgery, St George Hospital, South Eastern Sydney Local Health District, Sydney, NSW, Australia
  4. Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
  5. Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW, Australia
  6. Stats Central, Mark Wainwright Analytical Centre, University of New South Wales (UNSW), Sydney, NSW, Australia
  7. NSW Spine Specialists, Sydney, NSW, Australia
  8. Brain and Spine Surgery, Norwest Private Hospital, Sydney, NSW, Australia
  9. Department of Neurosurgery, St George Hospital, Sydney, NSW, Australia
  10. Royal Childrens Hospital, Melbourne, Victoria, Australia
  11. School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
  12. NeuroSpine Surgery Research Group (NSURG), Sydney, NSW, Australia
  13. Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW, Australia

Background

Degenerative Cervical Myelopathy (DCM) is the commonest cause of chronic spinal cord dysfunction worldwide.1 Existing evidence suggests that research on natural history of DCM remains inefficient with main focus being on evaluating surgical techniques and post-op outcomes of DCM patients.2 Natural history of DCM is a priority research theme as established by AO Spine RE-CODE DCM.3 A patient registry is an efficient approach to understand the natural history by systematically collecting patients’ health data in a temporal pattern. Registries provide benchmarks for clinical performance and provide evidence-based good clinical practice.

 

Aims

1.To describe the natural history of DCM.

2.To describe the influence of age, gender, smoking and BMI on outcome of DCM.

3.To describe the demographics, comorbidities, disease severity, quality of life and prognosis of DCM.

4.To identify and describe the pathways involved in metabolomics and proteomics associated with DCM.

 

Methodology

The MYNAH (MYelopathy NAtural History) study is a multicenter, prospective, non-interventional, observational cohort study enrolling patients with DCM from 10 participating study sites across Australia.

Inclusion criteria

1)All patients with DCM diagnosed by spine/neurosurgeon from 1st January 2018 onwards

2)Patients recorded with ICD-10 Codes: M50.0+, M50.1, M50.3, M47.1, G99.2 in SESLHD EMR databases

3)Patients who provide informed consent

Exclusion criteria

1)Patients with a cognitive decline or intellectual disability

2)Patients who are unable to or unwilling to provide informed consent

 

Shotgun proteomics

A global peptide-centered quantification of proteomes in the human plasma conducted by tandem mass spectrometry. High abundant proteins removed followed by trypsin digestion prior to analysis in LC-MS.

Global metabolomics

Polar and non-polar metabolites extracted from human serum samples and metabolites separated using LC and detected using LC-MS.

 

Conclusion

The MYNAH Registry (Registry ID: ACSQHC-ARCR-258) is listed on the Australian Register of Clinical Registries (the Register). Patient recruitment is active and fifty DCM patients have been recruited from approved study sites across Australia. The MYNAH Registry is Australia’s first patient registry to understand the natural history of DCM and analyses the metabolomics and proteomics holds potential for understanding the various pathways involved and in identifying possible biomarkers for DCM.