{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:30:25Z","timestamp":1790368225525,"version":"4.1.0"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007064","name":"NuVasive","doi-asserted-by":"publisher","award":["unrestricted research grants"],"award-info":[{"award-number":["unrestricted research grants"]}],"id":[{"id":"10.13039\/100007064","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007064","name":"NuVasive","doi-asserted-by":"publisher","award":["unrestricted research grants"],"award-info":[{"award-number":["unrestricted research grants"]}],"id":[{"id":"10.13039\/100007064","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007064","name":"NuVasive","doi-asserted-by":"publisher","award":["unrestricted research grant"],"award-info":[{"award-number":["unrestricted research grant"]}],"id":[{"id":"10.13039\/100007064","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001773","name":"University of New South Wales","doi-asserted-by":"publisher","award":["Postgraduate research award"],"award-info":[{"award-number":["Postgraduate research award"]}],"id":[{"id":"10.13039\/501100001773","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001773","name":"University of New South Wales","doi-asserted-by":"publisher","award":["postgraduate research award"],"award-info":[{"award-number":["postgraduate research award"]}],"id":[{"id":"10.13039\/501100001773","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004702","name":"Baxter International","doi-asserted-by":"publisher","award":["unrestricted research grants"],"award-info":[{"award-number":["unrestricted research grants"]}],"id":[{"id":"10.13039\/100004702","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004702","name":"Baxter International","doi-asserted-by":"publisher","award":["unrestricted research grants"],"award-info":[{"award-number":["unrestricted research grants"]}],"id":[{"id":"10.13039\/100004702","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004702","name":"Baxter International","doi-asserted-by":"publisher","award":["unrestricted research grant"],"award-info":[{"award-number":["unrestricted research grant"]}],"id":[{"id":"10.13039\/100004702","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Spinal Cord"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Study design<\/jats:title>\n            <jats:p>Scoping Review.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>Degenerative cervical myelopathy (DCM) is a leading cause of chronic spinal cord dysfunction, with diverse clinical presentations that complicate diagnosis. Therefore, it is important to identify the signs and symptoms of DCM that demonstrate high diagnostic accuracy. This review aims to evaluate the sensitivity and specificity of signs and symptoms in diagnosing DCM.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Articles up to June 2024 were retrieved from PubMed, EMBASE, and Cochrane databases using search terms like \u201cdegenerative cervical myelopathy\u201d, \u201ccervical spondylotic myelopathy\u201d, \u201csensitivity\u201d, \u201cspecificity\u201d, and related signs and symptoms. Studies were screened based on selection criteria assessing the sensitivity and specificity of signs or symptoms using an appropriate control group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Sixteen studies were included. The most sensitive signs were Tromner sign (93\u201397%) and hyperreflexia (15\u201385%). Specific signs included the Babinski sign (93\u2013100%), Tromner sign (79\u2013100%), clonus (96\u201399%), and inverted supinator sign (78\u201399%). Neck pain had a sensitivity of 76\u201394% and specificity of 11\u201373%. Hand incoordination showed 52% sensitivity and 92% specificity. Altered hand sensation had 76% sensitivity and 90% specificity. Upper extremity weakness had 51\u201375% sensitivity and 18\u201395% specificity. Gait imbalance exhibited 56\u201363% sensitivity and 52\u201395% specificity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Sensitive signs like the Tromner sign and hyperreflexia are useful for screening, while specific signs such as Babinski, clonus, and the inverted supinator sign aid in confirmation of DCM. Symptoms like neck pain, hand incoordination, and altered hand sensation should heighten suspicion and guide differential diagnosis. Early and accurate diagnosis using these indicators can improve patient outcomes and reduce diagnostic delays.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1038\/s41393-025-01065-1","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T15:04:35Z","timestamp":1740582275000},"page":"171-180","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Clinical signs and symptoms for degenerative cervical myelopathy: a scoping review of case-control studies to facilitate early diagnosis among healthcare professionals with stakeholder engagement"],"prefix":"10.1038","volume":"63","author":[{"given":"Suhani","family":"Sharma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisha","family":"Sial","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stone","family":"Sima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1037-8421","authenticated-orcid":false,"given":"Ashish","family":"Diwan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"1065_CR1","doi-asserted-by":"publisher","first-page":"39s","DOI":"10.1177\/21925682211036071","volume":"12","author":"A Nouri","year":"2022","unstructured":"Nouri A, Tessitore E, Molliqaj G, Meling T, Schaller K, Nakashima H, et al. Degenerative cervical myelopathy: development and natural history [AO spine RECODE-DCM research priority number 2]. Glob Spine J. 2022;12:39s\u201354s.","journal-title":"Glob Spine J"},{"key":"1065_CR2","doi-asserted-by":"publisher","first-page":"E675","DOI":"10.1097\/BRS.0000000000000913","volume":"40","author":"A Nouri","year":"2015","unstructured":"Nouri A, Tetreault L, Singh A, Karadimas SK, Fehlings MG. Degenerative cervical myelopathy: epidemiology, genetics, and pathogenesis. Spine. 2015;40:E675\u2013E93.","journal-title":"Spine"},{"key":"1065_CR3","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.jocn.2024.05.033","volume":"126","author":"AW Sial","year":"2024","unstructured":"Sial AW, Sima S, Chen X, Saulys C, Kuan J, Davies M, et al. Spinal column radiological factors associated with increased spinal cord intramedullary signal intensity\u2212 a study evaluating aging spinal cord\u2019s relation to spinal disc degeneration. J Clin Neurosci. 2024;126:86\u201394.","journal-title":"J Clin Neurosci"},{"key":"1065_CR4","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1038\/s41393-024-01041-1","volume":"62","author":"AW Sial","year":"2024","unstructured":"Sial AW, Sima S, Narulla R, Najib N, Davies M, Diwan AD. Is neck pain a marker for something serious? like myelopathy. Spinal Cord. 2024;62:718\u201320.","journal-title":"Spinal Cord"},{"key":"1065_CR5","doi-asserted-by":"publisher","first-page":"122s","DOI":"10.1177\/21925682211039835","volume":"12","author":"BM Davies","year":"2022","unstructured":"Davies BM, Phillips R, Clarke D, Furlan JC, Demetriades AK, Milligan J, et al. Establishing the socio-economic impact of degenerative cervical myelopathy is fundamental to improving outcomes [AO spine RECODE-DCM research priority number 8]. Glob Spine J. 2022;12:122s\u20139s.","journal-title":"Glob Spine J"},{"key":"1065_CR6","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1097\/BRS.0000000000003305","volume":"45","author":"DH Pope","year":"2020","unstructured":"Pope DH, Mowforth OD, Davies BM, Kotter MRN. Diagnostic delays lead to greater disability in degenerative cervical myelopathy and represent a health inequality. Spine. 2020;45:368\u201377.","journal-title":"Spine"},{"key":"1065_CR7","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1038\/s41582-019-0303-0","volume":"16","author":"JH Badhiwala","year":"2020","unstructured":"Badhiwala JH, Ahuja CS, Akbar MA, Witiw CD, Nassiri F, Furlan JC, et al. Degenerative cervical myelopathy\u2014update and future directions. Nat Rev Neurol. 2020;16:108\u201324.","journal-title":"Nat Rev Neurol"},{"key":"1065_CR8","doi-asserted-by":"publisher","first-page":"S21","DOI":"10.1097\/BRS.0b013e3182a7f2c3","volume":"38","author":"SK Karadimas","year":"2013","unstructured":"Karadimas SK, Erwin WM, Ely CG, Dettori JR, Fehlings MG. Pathophysiology and natural history of cervical spondylotic myelopathy. Spine. 2013;38:S21\u201336.","journal-title":"Spine"},{"key":"1065_CR9","doi-asserted-by":"publisher","first-page":"2038","DOI":"10.2106\/JBJS.O.00189","volume":"97","author":"L Tetreault","year":"2015","unstructured":"Tetreault L, Kopjar B, C\u00f4t\u00e9 P, Arnold P, Fehlings MG. A clinical prediction rule for functional outcomes in patients undergoing surgery for degenerative cervical myelopathy: analysis of an international prospective multicenter data set of 757 subjects. J Bone Jt Surg Am. 2015;97:2038\u201346.","journal-title":"J Bone Jt Surg Am"},{"key":"1065_CR10","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1093\/neuros\/nyy474","volume":"85","author":"L Tetreault","year":"2019","unstructured":"Tetreault L, Wilson JR, Kotter MRN, C\u00f4t\u00e9 P, Nouri A, Kopjar B, et al. Is preoperative duration of symptoms a significant predictor of functional outcomes in patients undergoing surgery for the treatment of degenerative cervical myelopathy? Neurosurgery. 2019;85:642\u20137.","journal-title":"Neurosurgery"},{"key":"1065_CR11","doi-asserted-by":"publisher","first-page":"70S","DOI":"10.1177\/2192568217701914","volume":"7","author":"MG Fehlings","year":"2017","unstructured":"Fehlings MG, Tetreault LA, Riew KD, Middleton JW, Aarabi B, Arnold PM, et al. A clinical practice guideline for the management of patients with degenerative cervical myelopathy: recommendations for patients with mild, moderate, and severe disease and nonmyelopathic patients with evidence of cord compression. Glob Spine J. 2017;7:70S\u201383S.","journal-title":"Glob Spine J"},{"key":"1065_CR12","doi-asserted-by":"publisher","first-page":"E1","DOI":"10.3171\/2013.3.FOCUS1374","volume":"35","author":"E Behrbalk","year":"2013","unstructured":"Behrbalk E, Salame K, Regev GJ, Keynan O, Boszczyk B, Lidar Z. Delayed diagnosis of cervical spondylotic myelopathy by primary care physicians. Neurosurg Focus. 2013;35:E1.","journal-title":"Neurosurg Focus"},{"key":"1065_CR13","doi-asserted-by":"publisher","first-page":"1881","DOI":"10.1177\/21925682211072847","volume":"12","author":"L Tetreault","year":"2022","unstructured":"Tetreault L, Kalsi-Ryan S, Benjamin D, Nanna-Lohkamp L, Garwood P, Martin AR, et al. Degenerative cervical myelopathy: a practical approach to diagnosis. Glob Spine J. 2022;12:1881\u201393.","journal-title":"Glob Spine J"},{"key":"1065_CR14","doi-asserted-by":"publisher","first-page":"503","DOI":"10.3390\/medicina57050503","volume":"57","author":"TF Monaghan","year":"2021","unstructured":"Monaghan TF, Rahman SN, Agudelo CW, Wein AJ, Lazar JM, Everaert K, et al. Foundational statistical principles in medical research: sensitivity, specificity, positive predictive value, and negative predictive value. Medicina. 2021;57:503.","journal-title":"Medicina"},{"key":"1065_CR15","doi-asserted-by":"publisher","first-page":"467","DOI":"10.7326\/M18-0850","volume":"169","author":"AC Tricco","year":"2018","unstructured":"Tricco AC, Lillie E, Zarin W, O\u2019Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169:467\u201373.","journal-title":"Ann Intern Med"},{"key":"1065_CR16","doi-asserted-by":"publisher","first-page":"e782","DOI":"10.1016\/j.wneu.2019.04.254","volume":"128","author":"J Cao","year":"2019","unstructured":"Cao J, Liu Y, Wang Y, Zhao L, Wang W, Zhang M, et al. A clinical correlation research of the Hoffmann sign and neurological imaging findings in cervical spinal cord compression. World Neurosurg. 2019;128:e782\u2013e6.","journal-title":"World Neurosurg"},{"key":"1065_CR17","doi-asserted-by":"publisher","first-page":"2621","DOI":"10.3390\/biomedicines10102621","volume":"10","author":"B He","year":"2022","unstructured":"He B, Sheldrick K, Das A, Diwan A. Clinical and research MRI techniques for assessing spinal cord integrity in degenerative cervical myelopathy-a scoping review. Biomedicines. 2022;10:2621.","journal-title":"Biomedicines"},{"key":"1065_CR18","doi-asserted-by":"publisher","first-page":"172","DOI":"10.2519\/jospt.2009.2938","volume":"39","author":"C Cook","year":"2009","unstructured":"Cook C, Roman M, Stewart KM, Leithe LG, Isaacs R. Reliability and diagnostic accuracy of clinical special tests for myelopathy in patients seen for cervical dysfunction. J Orthop Sports Phys Ther. 2009;39:172\u20138.","journal-title":"J Orthop Sports Phys Ther"},{"key":"1065_CR19","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1179\/106698110X12804993427045","volume":"18","author":"C Cook","year":"2010","unstructured":"Cook C, Brown C, Isaacs R, Roman M, Davis S, Richardson W. Clustered clinical findings for diagnosis of cervical spine myelopathy. J Man Manip Ther. 2010;18:175\u201380.","journal-title":"J Man Manip Ther"},{"key":"1065_CR20","doi-asserted-by":"publisher","first-page":"2108","DOI":"10.3390\/diagnostics12092108","volume":"12","author":"H Kobayashi","year":"2022","unstructured":"Kobayashi H, Otani K, Nikaido T, Watanabe K, Kato K, Kobayashi Y, et al. Development of a novel diagnostic support tool for degenerative cervical myelopathy combining 10-s grip and release test and grip strength: a pilot study. Diagnostics. 2022;12:2108.","journal-title":"Diagnostics"},{"key":"1065_CR21","doi-asserted-by":"publisher","first-page":"1369","DOI":"10.1177\/21925682231209869","volume":"14","author":"Z Jiang","year":"2024","unstructured":"Jiang Z, Davies B, Zipser C, Margetis K, Martin A, Matsoukas S, et al. The value of clinical signs in the diagnosis of degenerative cervical myelopathy - a systematic review and meta-analysis. Glob Spine J. 2024;14:1369\u201394.","journal-title":"Glob Spine J"},{"key":"1065_CR22","doi-asserted-by":"publisher","first-page":"2155","DOI":"10.1177\/21925682241237469","volume":"14","author":"S Matsoukas","year":"2024","unstructured":"Matsoukas S, Zipser CM, Zipser-Mohammadzada F, Kheram N, Boraschi A, Jiang Z, et al. Scoping review with topic modeling on the diagnostic criteria for degenerative cervical myelopathy. Glob Spine J. 2024;14:2155\u201369.","journal-title":"Glob Spine J"},{"key":"1065_CR23","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1007\/s00586-010-1681-6","volume":"20","author":"CW Chang","year":"2011","unstructured":"Chang CW, Chang KY, Lin SM. Quantification of the Tr\u00f6mner signs: a sensitive marker for cervical spondylotic myelopathy. Eur Spine J. 2011;20:923\u20137.","journal-title":"Eur Spine J"},{"key":"1065_CR24","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1097\/BRS.0b013e31819c944b","volume":"34","author":"JM Rhee","year":"2009","unstructured":"Rhee JM, Heflin JA, Hamasaki T, Freedman B. Prevalence of physical signs in cervical myelopathy: a prospective, controlled study. Spine. 2009;34:890\u20135.","journal-title":"Spine"},{"key":"1065_CR25","doi-asserted-by":"publisher","first-page":"e0281856","DOI":"10.1371\/journal.pone.0281856","volume":"18","author":"CF Munro","year":"2023","unstructured":"Munro CF, Yurac R, Moritz ZC, Fehlings MG, Rodrigues-Pinto R, Milligan J, et al. Targeting earlier diagnosis: What symptoms come first in degenerative cervical myelopathy? PLoS ONE. 2023;18:e0281856.","journal-title":"PLoS ONE"},{"key":"1065_CR26","doi-asserted-by":"publisher","first-page":"E1315","DOI":"10.1097\/BSD.0000000000000412","volume":"30","author":"W Chaiyamongkol","year":"2017","unstructured":"Chaiyamongkol W, Laohawiriyakamol T, Tangtrakulwanich B, Tanutit P, Bintachitt P, Siribumrungwong K. The significance of the Tr\u00f6mner sign in cervical spondylotic myelopathy patient. Clin Spine Surg. 2017;30:E1315\u2013e20.","journal-title":"Clin Spine Surg"},{"key":"1065_CR27","doi-asserted-by":"publisher","first-page":"565","DOI":"10.4300\/JGME-D-22-00621.1","volume":"14","author":"S Mak","year":"2022","unstructured":"Mak S, Thomas A. Steps for conducting a scoping review. J Grad Med Educ. 2022;14:565\u20137.","journal-title":"J Grad Med Educ"},{"key":"1065_CR28","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1097\/BRS.0b013e3181b723af","volume":"35","author":"JS Harrop","year":"2010","unstructured":"Harrop JS, Naroji S, Maltenfort M, Anderson DG, Albert T, Ratliff JK, et al. Cervical myelopathy: a clinical and radiographic evaluation and correlation to cervical spondylotic myelopathy. Spine. 2010;35:620\u20134.","journal-title":"Spine"},{"key":"1065_CR29","first-page":"49","volume":"21","author":"JA Glaser","year":"2001","unstructured":"Glaser JA, Cur\u00e9 JK, Bailey KL, Morrow DL. Cervical spinal cord compression and the Hoffmann sign. Iowa Orthop J. 2001;21:49\u201352.","journal-title":"Iowa Orthop J"},{"key":"1065_CR30","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1097\/BRS.0000000000000794","volume":"40","author":"RA Grijalva","year":"2015","unstructured":"Grijalva RA, Hsu FP, Wycliffe ND, Tsao BE, Williams P, Akpolat YT, et al. Hoffmann sign: clinical correlation of neurological imaging findings in the cervical spine and brain. Spine. 2015;40:475\u20139.","journal-title":"Spine"},{"key":"1065_CR31","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2019.105414","volume":"184","author":"M Machino","year":"2019","unstructured":"Machino M, Ando K, Kobayashi K, Morozumi M, Tanaka S, Ito K, et al. Cut off value in each gender and decade of 10-s grip and release and 10-s step test: a comparative study between 454 patients with cervical spondylotic myelopathy and 818 healthy subjects. Clin Neurol Neurosurg. 2019;184:105414.","journal-title":"Clin Neurol Neurosurg"},{"key":"1065_CR32","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.1097\/BRS.0000000000003610","volume":"45","author":"KR Archer","year":"2020","unstructured":"Archer KR, Bydon M, Khan I, Nian H, Pennings JS, Harrell FE Jr, et al. Development and validation of cervical prediction models for patient-reported outcomes at 1 year after cervical spine surgery for radiculopathy and myelopathy. Spine. 2020;45:1541\u201352.","journal-title":"Spine"},{"key":"1065_CR33","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1136\/jnnp.38.4.386","volume":"38","author":"DG Phillips","year":"1975","unstructured":"Phillips DG. Upper limb involvement in cervical spondylosis. J Neurol Neurosurg Psychiatry. 1975;38:386\u201390.","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"1065_CR34","unstructured":"Soufi K, Balatbat P, Perez T, Martin A. Improving diagnosis and early detection of degenerative cervical myelopathy (DCM): a prospective cohort study. Paper presented at: Global Spine Congress; 2024 May 15-18; Bangkok; Thailand."},{"key":"1065_CR35","doi-asserted-by":"publisher","first-page":"E242","DOI":"10.1097\/BRS.0000000000002287","volume":"43","author":"PWH Cheung","year":"2018","unstructured":"Cheung PWH, Wong CKH, Lau ST, Cheung JPY. Psychometric validation of the adapted traditional Chinese (Hong Kong) version of the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). Spine. 2018;43:E242\u2013e9.","journal-title":"Spine"},{"key":"1065_CR36","doi-asserted-by":"publisher","first-page":"1797","DOI":"10.1007\/s00330-012-2410-9","volume":"22","author":"M Hori","year":"2012","unstructured":"Hori M, Fukunaga I, Masutani Y, Nakanishi A, Shimoji K, Kamagata K, et al. New diffusion metrics for spondylotic myelopathy at an early clinical stage. Eur Radiol. 2012;22:1797\u2013802.","journal-title":"Eur Radiol"},{"key":"1065_CR37","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/j.thromres.2017.06.002","volume":"163","author":"JA Kline","year":"2018","unstructured":"Kline JA. Diagnosis and exclusion of pulmonary embolism. Thromb Res. 2018;163:207\u201320.","journal-title":"Thromb Res"},{"key":"1065_CR38","doi-asserted-by":"publisher","first-page":"65s","DOI":"10.1177\/2192568219832855","volume":"9","author":"BM Davies","year":"2019","unstructured":"Davies BM, Khan DZ, Mowforth OD, McNair AGK, Gronlund T, Kolias AG, et al. RE-CODE DCM (REsearch objectives and common data elements for degenerative cervical myelopathy): a consensus process to improve research efficiency in DCM, through establishment of a standardized dataset for clinical research and the definition of the research priorities. Glob Spine J. 2019;9:65s\u201376s.","journal-title":"Glob Spine J"},{"key":"1065_CR39","doi-asserted-by":"publisher","first-page":"5s","DOI":"10.1177\/21925682211035379","volume":"12","author":"BM Davies","year":"2022","unstructured":"Davies BM, Kwon BK, Fehlings MG, Kotter MRN. AO spine RECODE-DCM: why prioritize research in degenerative cervical myelopathy? Glob Spine J. 2022;12:5s\u20137s.","journal-title":"Glob Spine J"},{"key":"1065_CR40","doi-asserted-by":"publisher","first-page":"907","DOI":"10.3171\/2019.10.SPINE19685","volume":"32","author":"TS Cole","year":"2020","unstructured":"Cole TS, Almefty KK, Godzik J, Muma AH, Hlubek RJ, Martinez-Del-Campo E, et al. Functional improvement in hand strength and dexterity after surgical treatment of cervical spondylotic myelopathy: a prospective quantitative study. J Neurosurg Spine. 2020;32:907\u201313.","journal-title":"J Neurosurg Spine"},{"key":"1065_CR41","doi-asserted-by":"publisher","first-page":"1594","DOI":"10.1002\/acr.20270","volume":"62","author":"AP Goode","year":"2010","unstructured":"Goode AP, Freburger J, Carey T. Prevalence, practice patterns, and evidence for chronic neck pain. Arthritis Care Res. 2010;62:1594\u2013601.","journal-title":"Arthritis Care Res"},{"key":"1065_CR42","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1136\/ard.2003.019349","volume":"64","author":"SD Bot","year":"2005","unstructured":"Bot SD, van der Waal JM, Terwee CB, van der Windt DA, Schellevis FG, Bouter LM, et al. Incidence and prevalence of complaints of the neck and upper extremity in general practice. Ann Rheum Dis. 2005;64:118\u201323.","journal-title":"Ann Rheum Dis"},{"key":"1065_CR43","doi-asserted-by":"publisher","first-page":"3626","DOI":"10.3390\/jcm10163626","volume":"10","author":"M Lannon","year":"2021","unstructured":"Lannon M, Kachur E. Degenerative cervical myelopathy: clinical presentation, assessment, and natural history. J Clin Med. 2021;10:3626.","journal-title":"J Clin Med"},{"key":"1065_CR44","doi-asserted-by":"publisher","first-page":"752","DOI":"10.3390\/jcm9030752","volume":"9","author":"S Kalsi-Ryan","year":"2020","unstructured":"Kalsi-Ryan S, Rienmueller AC, Riehm L, Chan C, Jin D, Martin AR, et al. Quantitative assessment of gait characteristics in degenerative cervical myelopathy: a prospective clinical study. J Clin Med. 2020;9:752.","journal-title":"J Clin Med"}],"container-title":["Spinal Cord"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41393-025-01065-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41393-025-01065-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41393-025-01065-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T12:06:22Z","timestamp":1741867582000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41393-025-01065-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,26]]},"references-count":44,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["1065"],"URL":"https:\/\/doi.org\/10.1038\/s41393-025-01065-1","relation":{},"ISSN":["1362-4393","1476-5624"],"issn-type":[{"value":"1362-4393","type":"print"},{"value":"1476-5624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,26]]},"assertion":[{"value":"28 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 February 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 February 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Alisha Sial and Stone Sima were supported by university postgraduate award from the University of New South Wales. Spine Labs is supported by unrestricted research grants from Baxter inc. and Globus\/Nuvasive inc. The Authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}