{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:18:07Z","timestamp":1790702287498,"version":"4.1.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2018,4,19]],"date-time":"2018-04-19T00:00:00Z","timestamp":1524096000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/ mailto:journals.permissions@oup.com"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>There is controversy over the optimal treatment strategy for patients with mild degenerative cervical myelopathy (DCM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To evaluate the degree of impairment in baseline quality of life as compared to population norms, as well as functional, disability, and quality of life outcomes following surgery in a prospective cohort of mild DCM patients undergoing surgical decompression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We identified patients with mild DCM (modified Japanese Orthopaedic Association [mJOA] 15 to 17) enrolled in the prospective, multicenter AOSpine CSM-NA or CSM-I trials. Baseline quality of life Short Form-36 version 2 (SF-36v2) was compared to population norms by the standardized mean difference (SMD). Outcomes, including functional status (mJOA, Nurick grade), disability (NDI [Neck Disability Index]), and quality of life (SF-36v2), were evaluated at baseline and 6 mo, 1 yr, and 2 yr after surgery. Postoperative complications within 30 d of surgery were monitored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      One hundred ninety-three patients met eligibility criteria. Mean age was 52.4 yr. There were 67 females (34.7%). Patients had significant impairment in all domains of the SF-36v2 compared to population norms, greatest for Social Functioning (SMD \u20132.33), Physical Functioning (SMD \u20132.31), and Mental Health (SMD \u20132.30). A significant improvement in mean score from baseline to 2-yr follow-up was observed for all major outcome measures, including mJOA (0.87,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a0.01), Nurick grade (\u20131.13,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a0.01), NDI (\u201312.97,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a0.01), and SF-36v2 Physical Component Summary (PCS) (5.75,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a0.01) and Mental Component Summary (MCS) (6.93,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a0.01). The rate of complication was low.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Mild DCM is associated with significant impairment in quality of life. Surgery results in significant gains in functional status, level of disability, and quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuros\/nyy133","type":"journal-article","created":{"date-parts":[[2018,3,27]],"date-time":"2018-03-27T15:22:03Z","timestamp":1522164123000},"page":"890-897","source":"Crossref","is-referenced-by-count":74,"title":["Efficacy and Safety of Surgery for Mild Degenerative Cervical Myelopathy: Results of the AOSpine North America and International Prospective Multicenter Studies"],"prefix":"10.1227","volume":"84","author":[{"given":"Jetan H","family":"Badhiwala","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D","family":"Witiw","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farshad","family":"Nassiri","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad A","family":"Akbar","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Mansouri","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jefferson R","family":"Wilson","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G","family":"Fehlings","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,4]]},"reference":[{"issue":"1","key":"bib1-20231011","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/brain\/95.1.87","article-title":"The pathogenesis of the spinal cord disorder associated with cervical spondylosis","volume":"95","author":"Nurick","year":"1972","journal-title":"Brain"},{"issue":"2","key":"bib2-20231011","first-page":"196","article-title":"Necropsy observations on the spinal cord in cervical spondylosis","volume":"86","author":"Hughes","year":"1965","journal-title":"Riv Patol Nerv Ment"},{"issue":"6","key":"bib3-20231011","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1097\/00007632-198607000-00003","article-title":"Roentgenographic findings of the cervical spine in asymptomatic people","volume":"11","author":"Gore","year":"1986","journal-title":"Spine (Phila Pa 1976)"},{"issue":"7395","key":"bib4-20231011","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1016\/S0140-6736(65)92674-7","article-title":"Prevalence of cervical spondylosis in a general practice","volume":"1","author":"Irvine","year":"1965","journal-title":"Lancet North Am Ed"},{"key":"bib5-20231011","year":"2017","journal-title":"DataBank: Population Estimates and Projections"},{"issue":"2","key":"bib6-20231011","doi-asserted-by":"crossref","first-page":"104","DOI":"10.3171\/2009.1.SPINE08716","article-title":"The natural history of cervical spondylotic myelopathy","volume":"11","author":"Matz","year":"2009","journal-title":"J Neurosurg Spine"},{"issue":"2","key":"bib7-20231011","doi-asserted-by":"crossref","first-page":"97","DOI":"10.3171\/2009.5.SPINE09210","article-title":"Surgical management of cervical degenerative disease: the evidence related to indications, impact, and outcome","volume":"11","author":"Fehlings","year":"2009","journal-title":"J Neurosurg Spine"},{"issue":"22 Suppl 1","key":"bib8-20231011","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1097\/BRS.0b013e3182a7f2c3","article-title":"Pathophysiology and natural history of cervical spondylotic myelopathy","volume":"38","author":"Karadimas","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"issue":"18","key":"bib9-20231011","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.2106\/JBJS.L.00589","article-title":"Efficacy and safety of surgical decompression in patients with cervical spondylotic myelopathy","volume":"95","author":"Fehlings","year":"2013","journal-title":"J Bone Joint Surg Am"},{"issue":"17","key":"bib10-20231011","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1097\/BRS.0000000000000988","article-title":"A global perspective on the outcomes of surgical decompression in patients with cervical spondylotic myelopathy","volume":"40","author":"Fehlings","year":"2015","journal-title":"Spine (Phila Pa 1976)"},{"issue":"10","key":"bib11-20231011","doi-asserted-by":"crossref","first-page":"S113","DOI":"10.1016\/j.spinee.2016.07.002","article-title":"Guidelines for the management of patients with degenerative cervical myelopathy","volume":"16","author":"Tetreault","journal-title":"Spine J"},{"issue":"1","key":"bib12-20231011","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1007\/s00586-016-4660-8","article-title":"The modified Japanese Orthopaedic Association scale: establishing criteria for mild, moderate and severe impairment in patients with degenerative cervical myelopathy","volume":"26","author":"Tetreault","year":"2017","journal-title":"Eur Spine J"},{"issue":"3","key":"bib13-20231011","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1097\/00002517-199109000-00005","article-title":"Cervical laminectomy and dentate ligament section for cervical spondylotic myelopathy","volume":"4","author":"Benzel","year":"1991","journal-title":"J Spinal Disord"},{"issue":"1","key":"bib14-20231011","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1093\/brain\/95.1.101","article-title":"The natural history and the results of surgical treatment of the spinal cord disorder associated with cervical spondylosis","volume":"95","author":"Nurick","year":"1972","journal-title":"Brain"},{"issue":"3","key":"bib15-20231011","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1097\/00005650-199303000-00006","article-title":"The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs","volume":"31","author":"McHorney","year":"1993","journal-title":"Med Care"},{"issue":"6","key":"bib16-20231011","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.spinee.2010.02.007","article-title":"Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion","volume":"10","author":"Carreon","year":"2010","journal-title":"Spine J"},{"issue":"7","key":"bib17-20231011","first-page":"409","article-title":"The Neck Disability Index: a study of reliability and validity","volume":"14","author":"Vernon","year":"1991","journal-title":"J Manipulative Physiol Ther"},{"issue":"2","key":"bib18-20231011","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/S0167-6296(01)00130-8","article-title":"The estimation of a preference-based measure of health from the SF-36","volume":"21","author":"Brazier","year":"2002","journal-title":"J Health Econ"},{"issue":"9176","key":"bib19-20231011","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/S0140-6736(98)10199-X","article-title":"Quantitative assessment of cervical spondylotic my elopathy by a simple walking test","volume":"354","author":"Singh","year":"1999","journal-title":"Lancet North Am Ed"},{"issue":"6","key":"bib20-20231011","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1007\/s005860000132","article-title":"Conservative treatment versus surgery in spondylotic cervical myelopathy: a prospective randomised study","volume":"9","author":"Kadanka","year":"2000","journal-title":"Eur Spine J"},{"issue":"3","key":"bib21-20231011","first-page":"265","article-title":"Canadian normative data for the SF-36 health survey. canadian multicentre osteoporosis study research group","volume":"163","author":"Hopman","year":"2000","journal-title":"CMAJ"},{"issue":"20","key":"bib23-20231011","doi-asserted-by":"crossref","first-page":"2205","DOI":"10.1097\/00007632-200210150-00003","article-title":"Approaches to spondylotic cervical myelopathy: conservative versus surgical results in a 3-year follow-up study","volume":"27","author":"Kadanka","year":"2002","journal-title":"Spine (Phila Pa 1976)"},{"issue":"1","key":"bib24-20231011","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/j.1468-1331.2004.00947.x","article-title":"Predictive factors for mild forms of spondylotic cervical myelopathy treated conservatively or surgically","volume":"12","author":"Kadanka","year":"2005","journal-title":"Eur J Neurol"},{"issue":"12","key":"bib25-20231011","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1002\/hec.1823","article-title":"Sf-6d population norms","volume":"21","author":"van den Berg","year":"2012","journal-title":"Health Econ"},{"issue":"4","key":"bib26-20231011","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/j.spinee.2014.12.009","article-title":"Is neck pain associated with worse health-related quality of life 6 months later? A population-based cohort study","volume":"15","author":"Nolet","year":"2015","journal-title":"Spine J"},{"issue":"5","key":"bib27-20231011","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1097\/AJP.0b013e318232cddc","article-title":"Patient satisfaction after anterior cervical discectomy and fusion is primarily driven by relieving pain","volume":"28","author":"Hessler","year":"2012","journal-title":"Clin J Pain"},{"issue":"1","key":"bib28-20231011","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/1477-7525-1-4","article-title":"What is the relationship between the minimally important difference and health state utility values? The case of the SF-6D","volume":"1","author":"Walters","year":"2003","journal-title":"Health Qual Life Outcomes"},{"issue":"12","key":"bib29-20231011","doi-asserted-by":"crossref","first-page":"2918","DOI":"10.1007\/s00586-015-4208-3","article-title":"Assessment of the minimum clinically important difference in neurological function and quality of life after surgery in cervical spondylotic myelopathy patients: a prospective cohort study","volume":"24","author":"Zhou","year":"2015","journal-title":"Eur Spine J"},{"issue":"10","key":"bib30-20231011","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1016\/j.spinee.2009.06.002","article-title":"Responsiveness of the Neck Disability Index in patients with mechanical neck disorders","volume":"9","author":"Young","year":"2009","journal-title":"Spine J"},{"issue":"2","key":"bib31-20231011","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.spinee.2016.08.033","article-title":"Psychometric properties of the 30-m walking test in patients with degenerative cervical myelopathy: results from two prospective multicenter cohort studies","volume":"17","author":"Bohm","year":"2017","journal-title":"Spine J"},{"issue":"6","key":"bib32-20231011","doi-asserted-by":"crossref","first-page":"E11","DOI":"10.3171\/2016.3.FOCUS1669","article-title":"Surgical outcomes of cervical spondylotic myelopathy: an analysis of a national, administrative, longitudinal database","volume":"40","author":"Veeravagu","year":"2016","journal-title":"Neurosurg Focus"},{"issue":"3","key":"bib33-20231011","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.surneu.2007.09.036","article-title":"Surgical outcomes of elderly patients with cervical spondylotic myelopathy","volume":"69","author":"Holly","year":"2008","journal-title":"Surg Neurol"},{"issue":"2","key":"bib34-20231011","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1227\/01.neu.0000316013.97926.4c","article-title":"Cervical spondylotic myelopathy: complications and outcomes after spinal fusion","volume":"62","author":"Boakye","year":"2008","journal-title":"Neurosurgery"},{"issue":"3_suppl","key":"bib35-20231011","doi-asserted-by":"crossref","first-page":"53S","DOI":"10.1177\/2192568217710137","article-title":"Change in functional impairment, disability, and quality of life following operative treatment for degenerative cervical myelopathy: a systematic review and meta-analysis","volume":"7","author":"Fehlings","year":"2017","journal-title":"Global Spine J"},{"issue":"1","key":"bib36-20231011","doi-asserted-by":"crossref","first-page":"E23","DOI":"10.1097\/BRS.0000000000000648","article-title":"Psychometric properties of the modified Japanese Orthopaedic Association scale in patients with cervical spondylotic myelopathy","volume":"40","author":"Kopjar","year":"2015","journal-title":"Spine (Phila Pa 1976)"},{"issue":"Suppl 1","key":"bib37-20231011","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1227\/NEU.0000000000000781","article-title":"Surgery vs conservative care for cervical spondylotic myelopathy: surgery is appropriate for progressive myelopathy","volume":"62","author":"Ghogawala","year":"2015","journal-title":"Neurosurgery"}],"container-title":["Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00006123-201904000-00009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:52:04Z","timestamp":1786121524000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00006123-201904000-00009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,19]]},"references-count":36,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1093\/neuros\/nyy133","relation":{},"ISSN":["0148-396X","1524-4040"],"issn-type":[{"value":"0148-396X","type":"print"},{"value":"1524-4040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,19]]}}}