ArticleNorth American Spine Society journal2026
Association between perioperative patient-reported outcomes and upper extremity functional performance in degenerative cervical myelopathy.
Article in North American Spine Society journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Degenerative cervical myelopathy (DCM) is caused by chronic compression of the cervical spinal cord. Individuals usually present with a combination of upper extremity dysfunction, imbalance, and bladder dysfunction, which impact overall quality of life. Various questionnaires like mJOA, Nurick, NDI, and DCM-72 have been used for disease stratification. Our study aims to evaluate the clinical correlation between self-reported measures and objective upper extremity assessments and to derive the minimal clinically important difference (MCID) for individuals with DCM. Methods: A prospective two-center study of consecutive patients diagnosed with DCM was undertaken. A comprehensive assessment of upper extremity functioning including dexterity, sensation, and muscle strength, as well as self-reported questionnaires were completed preoperatively, and at 6- and 12-months postoperative follow-up. Statistical analyses were conducted to evaluate the progression of self-reported measures postoperatively and to evaluate correlations with upper extremity functional assessments. A p-value <.05 was deemed statistically significant. Results: A total of 99 patients with DCM and 34 controls were followed up over a period of 12 months. Significant differences were observed in mJOA overall scores and subscores, NDI, Nurick, and PROMIS-10 Physical scores. Various upper extremity functional measures significantly correlated with the self-reported outcome measures, highlighting the correlation between functional impairment and diminished quality of life. Using mJOA at 6-months follow-up as an anchor, DCM-72 MCID values of 1.44, 3.20, and 6.92 were approximated for mild, moderate and severe DCM, respectively. Conclusions: Individuals with DCM experience significant postoperative improvements in self-reported outcomes, and upper extremity functioning strongly correlates with these gains. The DCM-72 MCID values offer clinically relevant thresholds for composite upper extremity functional recovery.
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