{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T17:13:47Z","timestamp":1788369227788,"version":"build-2803163510"},"reference-count":21,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Prospective multicenter observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To redefine mild degenerative cervical myelopathy (DCM) using a patient-reported severity framework derived from Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) and to compare surgical outcomes with the conventional clinician-reported definition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with DCM undergoing surgery at 10 spine centers were enrolled. Mild DCM was defined using two criteria: a clinician-reported definition based on Japanese Orthopaedic Association (JOA) score (\u2267 14.5) and a patient-reported definition derived from principal component analysis of JOACMEQ domains and Numerical Rating Scale (NRS) pain scores. Patients were categorized into four groups: Dual-Mild, Clinician-Mild, Patient-Mild, and Non-Mild. Postoperative outcomes were assessed using achievement of minimum clinically important difference (MCID) for JOA score, JOACMEQ, NRS, and Short Form-36 (SF-36). Multivariable logistic regression models were used to estimate adjusted probabilities of MCID achievement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 930 eligible patients, 122 met criteria for mild DCM by each definition. Patients classified as Patient-Mild demonstrated higher baseline function and lower pain scores but showed significantly lower adjusted probabilities of achieving MCID in pain-related outcomes and SF-36 physical component summary (PCS) (odds ratio for PCS, 0.346 [0.196-0.589]; p &lt; 0.001). In contrast, Clinician-Mild status was associated with sustained postoperative improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Definitions of mild DCM differ substantially between clinician- and patient-reported criteria. Patients who perceive their disease as mild exhibit limited postoperative improvement. Incorporating patient-reported severity into preoperative assessment may better inform expectations and shared decision-making regarding surgery in mild DCM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261484089","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:10:45Z","timestamp":1788171045000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Discrepancy Between Clinician- and Patient-Reported Definitions of Mild Degenerative Cervical Myelopathy and Surgical Outcomes"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6746-8546","authenticated-orcid":false,"given":"Takahiro","family":"Kitagawa","sequence":"first","affiliation":[{"name":"National Hospital Organization"},{"name":"Murayama Medical Center"},{"name":"Keio Spine Research Group 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Organization"},{"name":"Murayama Medical Center"},{"name":"Keio Spine Research Group (KSRG)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiomi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"National Hospital Organization"},{"name":"Murayama Medical Center"},{"name":"Keio Spine Research Group (KSRG)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanehiro","family":"Fujiyoshi","sequence":"additional","affiliation":[{"name":"National Hospital Organization"},{"name":"Murayama Medical Center"},{"name":"Keio Spine Research Group (KSRG)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyuki","family":"Yato","sequence":"additional","affiliation":[{"name":"National Hospital Organization"},{"name":"Murayama Medical Center"},{"name":"Keio Spine Research Group 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