{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T18:54:00Z","timestamp":1779130440128,"version":"3.51.4"},"reference-count":7,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2009,8]]},"abstract":"\nObject<\/jats:title>\nThe objective of this systematic review was to use evidence-based medicine to examine the efficacy of anterior cervical surgery for the treatment of cervical spondylotic myelopathy (CSM).<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nThe National Library of Medicine and Cochrane Database were queried using MeSH headings and key words relevant to anterior cervical surgery and CSM. Abstracts were reviewed, and studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I\u2013III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons\/Congress of Neurological Surgeons.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nMild CSM (modified Japanese Orthopaedic Association [mJOA] scale scores > 12) responds in the short term (3 years) to either surgical decompression or nonoperative therapy (prolonged immobilization in a stiff cervical collar, \u201clow-risk\u201d activity modification or bed rest, and antiinflammatory medications) (Class II). More severe CSM responds to surgical decompression with benefits being maintained a minimum of 5 years and as long as 15 years postoperatively (Class III).<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nTreatment of mild CSM may involve surgical decompression or nonoperative therapy for the first 3 years after diagnosis. More severe CSM (mJOA scale score \u2264 12) should be considered for surgery depending upon the individual case. The shortcomings of this systematic review are that the group was not able to determine whether an mJOA scale score of 12 was indicative of a more severe CSM disease course, and whether patients who received nonsurgical treatment for 3 years had a significant probability for clinical deterioration after that time point.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.3.spine08724","type":"journal-article","created":{"date-parts":[[2011,2,23]],"date-time":"2011-02-23T21:42:06Z","timestamp":1298497326000},"page":"170-173","source":"Crossref","is-referenced-by-count":42,"title":["Anterior cervical surgery for the treatment of cervical degenerative myelopathy"],"prefix":"10.3171","volume":"11","author":[{"given":"Paul G.","family":"Matz","sequence":"first","affiliation":[{"name":"Division of Neurological Surgery, University of Alabama, Birmingham, Alabama;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Langston T.","family":"Holly","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, David Geffen School of Medicine, University of California at Los Angeles;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Praveen V.","family":"Mummaneni","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California at San Francisco, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul A.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael W.","family":"Groff","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert F.","family":"Heary","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Medicine and Dentistry of New Jersey\u2014New Jersey Medical School, Newark, New Jersey;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael G.","family":"Kaiser","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Neurological Institute, Columbia University, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy C.","family":"Ryken","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanvir F.","family":"Choudhri","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mount Sinai School of Medicine, New York, New York; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward J.","family":"Vresilovic","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Milton S. Hershey Medical Center, Pennsylvania State College of Medicine, Hershey, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel K.","family":"Resnick","sequence":"additional","affiliation":[{"name":"Neurological Surgery, University of Wisconsin, Madison, Wisconsin;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-0110170","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1593","DOI":"10.1097\/00007632-199908010-00014","article-title":"The value of somatosensory- and motor-evoked potentials in predicting and monitoring the effect of therapy in spondylotic cervical myelopathy. Prospective randomized study","volume":"24","author":"Bednarik","year":"1999"},{"key":"b2-0110170","series-title":"Cochrane Database Syst Rev","first-page":"CD001466","article-title":"Surgery for cervical radiculomyelopathy","volume":"3","author":"Fouyas","year":"2001"},{"key":"b3-0110170","series-title":"Eur Spine J","doi-asserted-by":"publisher","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"},{"key":"b4-0110170","series-title":"Eur J Neurol","doi-asserted-by":"publisher","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"},{"issue":"6 Suppl","key":"b5-0110170","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"175S","DOI":"10.1016\/j.spinee.2006.03.015","article-title":"Does nonoperative management play a role in the treatment of cervical spondylotic myelopathy?","volume":"6","author":"Matz","year":"2006"},{"key":"b6-0110170","series-title":"Spine","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1097\/00007632-200003150-00004","article-title":"Outcome of patients treated for cervical myelopathy. A prospective, multicenter study with independent clinical review","volume":"25","author":"Sampath","year":"2000"},{"key":"b7-0110170","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1097\/00007632-200107010-00011","article-title":"Subtotal corpectomy versus laminoplasty for multilevel cervical spondylotic myelopathy: a long-term follow-up study over 10 years","volume":"26","author":"Wada","year":"2001"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/11\/2\/article-p170.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/11\/2\/article-p170.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/11\/2\/article-p170.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T21:36:26Z","timestamp":1681594586000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/11\/2\/article-p170.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,8]]},"references-count":7,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2009.3.spine08724","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2009,8]]}}}