{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:13:41Z","timestamp":1793830421736,"version":"4.6.1"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The aim of this study was to identify predictors of the best 24-month improvements in patients undergoing surgery for cervical spondylotic myelopathy (CSM). For this purpose, the authors leveraged a large prospective cohort of surgically treated patients with CSM to identify factors predicting the best outcomes for disability, quality of life, and functional status following surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This was a retrospective analysis of prospectively collected data. The Quality Outcomes Database (QOD) CSM dataset (1141 patients) at 14 top enrolling sites was used. Baseline and surgical characteristics were compared for those reporting the top and bottom 20th percentile 24-month Neck Disability Index (NDI), EuroQol-5D (EQ-5D), and modified Japanese Orthopaedic Association (mJOA) change scores. A multivariable logistic model was constructed and included candidate variables reaching p \u2264 0.20 on univariate analyses. Least important variables were removed in a stepwise manner to determine the significant predictors of the best outcomes (top 20th percentile) for 24-month NDI, EQ-5D, and mJOA change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      A total of 948 (83.1%) patients with 24-month follow-up were included in this study. For NDI, 204 (17.9%) had the best NDI outcome and 200 (17.5%) had the worst NDI outcome. Factors predicting the best NDI outcomes included symptom duration less than 12 months (OR 1.5, 95% CI 1.1\u20131.9; p = 0.01); procedure other than posterior fusion (OR 1.5, 95% CI 1.03\u20132.1; p = 0.03); higher preoperative visual analog scale neck pain score (OR 1.2, 95% CI 1.1\u20131.3; p &lt; 0.001); and higher baseline NDI (OR 1.06, 95% CI 1.05\u20131.07; p &lt; 0.001). For EQ-5D, 163 (14.3%) had the best EQ-5D outcome and 169 (14.8%) had the worst EQ-5D outcome. Factors predicting the best EQ-5D outcomes included arm pain\u2013only complaints (compared to neck pain) (OR 1.9, 95% CI 1.3\u20132.9; p = 0.002) and lower baseline EQ-5D (OR 167.7 per unit lower, 95% CI 85.0\u2013339.4; p &lt; 0.001). For mJOA, 222 (19.5%) had the best mJOA outcome and 238 (20.9%) had the worst mJOA outcome. Factors predicting the best mJOA outcomes included lower BMI (OR 1.03 per unit lower, 95% CI 1.004\u20131.05; p = 0.02; cutoff value of \u2264 29.5 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ); arm pain\u2013only complaints (compared to neck pain) (OR 1.7, 95% CI 1.1\u20132.5; p = 0.02); and lower baseline mJOA (OR 1.6 per unit lower, 95% CI 1.5\u20131.7; p &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Compared to the worst outcomes for EQ-5D, the best outcomes were associated with patients with arm pain\u2013only complaints. For mJOA, lower BMI and arm pain\u2013only complaints portended the best outcomes. For NDI, those with the best outcomes had shorter symptom durations, higher preoperative neck pain scores, and less often underwent posterior spinal fusions. Given the positive impact of shorter symptom duration on outcomes, these data suggest that early surgery may be beneficial for patients with CSM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2023.11.spine23222","type":"journal-article","created":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T23:13:59Z","timestamp":1704496439000},"page":"453-464","source":"Crossref","is-referenced-by-count":9,"title":["What predicts the best 24-month outcomes following surgery for cervical spondylotic myelopathy? A QOD prospective registry study"],"prefix":"10.3171","volume":"40","author":[{"given":"Andrew K.","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York; The Och Spine Hospital at NewYork-Presbyterian, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oren N.","family":"Gottfried","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khoi D.","family":"Than","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica F.","family":"Bisson","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Bydon","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony L.","family":"Asher","sequence":"additional","affiliation":[{"name":"Neuroscience Institute, Carolinas Healthcare System and Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domagoj","family":"Coric","sequence":"additional","affiliation":[{"name":"Neuroscience Institute, Carolinas Healthcare System and Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric A.","family":"Potts","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Indianapolis, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin T.","family":"Foley","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee; Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai-Ming","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Weill Cornell Medical Center, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Virk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Weill Cornell Medical Center, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Knightly","sequence":"additional","affiliation":[{"name":"Atlantic Neurosurgical Specialists, Morristown, New Jersey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Meyer","sequence":"additional","affiliation":[{"name":"Atlantic Neurosurgical Specialists, Morristown, New Jersey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheerag D.","family":"Upadhyaya","sequence":"additional","affiliation":[{"name":"Marion Bloch Neuroscience Institute, Saint Luke\u2019s Health System, Kansas City, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark E.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avery L.","family":"Buchholz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis M.","family":"Tumial\u00e1n","sequence":"additional","affiliation":[{"name":"Barrow Neurological Institute, Phoenix, Arizona;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay D.","family":"Turner","sequence":"additional","affiliation":[{"name":"Barrow Neurological Institute, Phoenix, Arizona;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgos","family":"Michalopoulos","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon A.","family":"Sherrod","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York; The Och Spine Hospital at NewYork-Presbyterian, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regis W.","family":"Haid","sequence":"additional","affiliation":[{"name":"Atlanta Brain and Spine Care, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen V.","family":"Mummaneni","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"suppl 4","key":"b1","series-title":"Neurosurgery","first-page":"S51","article-title":"Degenerative cervical myelopathy: a spectrum of related disorders affecting the aging spine","volume":"77","author":"Tetreault L","year":"2015","unstructured":"Tetreault L, Goldstein CL, Arnold P,  Degenerative cervical myelopathy: a spectrum of related disorders affecting the aging spine. Neurosurgery. 2015;77(suppl 4):S51-S67."},{"issue":"4","key":"b2","series-title":"Neurosurgery","first-page":"890","article-title":"Efficacy and safety of surgery for mild degenerative cervical myelopathy: results of the AOSpine North America and international prospective multicenter studies","volume":"84","author":"Badhiwala JH","year":"2019","unstructured":"Badhiwala JH, Witiw CD, Nassiri F,  Efficacy and safety of surgery for mild degenerative cervical myelopathy: results of the AOSpine North America and international prospective multicenter studies. 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J Neurosurg Spine. 2022;37(3):339\u2013349."},{"issue":"17","key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"1322","article-title":"A global perspective on the outcomes of surgical decompression in patients with cervical spondylotic myelopathy: results from the prospective multicenter AOSpine international study on 479 patients","volume":"40","author":"Fehlings MG","year":"2015","unstructured":"Fehlings MG, Ibrahim A, Tetreault L,  A global perspective on the outcomes of surgical decompression in patients with cervical spondylotic myelopathy: results from the prospective multicenter AOSpine international study on 479 patients. 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Neurosurgery. 2020;87(6):1130\u20131138."},{"issue":"4","key":"b12","series-title":"J Neurosurg Spine","first-page":"568","article-title":"Association of \u2265 12 months of delayed surgical treatment for cervical myelopathy with worsened postoperative outcomes: a multicenter analysis of the Quality Outcomes Database","volume":"36","author":"Asuzu DT","year":"2021","unstructured":"Asuzu DT, Yun JJ, Alvi MA,  Association of \u2265 12 months of delayed surgical treatment for cervical myelopathy with worsened postoperative outcomes: a multicenter analysis of the Quality Outcomes Database. J Neurosurg Spine. 2021;36(4):568\u2013574."},{"issue":"1","key":"b13","series-title":"J Neurosurg Spine","first-page":"25","article-title":"Identifying patients at risk for nonroutine discharge after surgery for cervical myelopathy: an analysis from the Quality Outcomes Database","volume":"35","author":"Mummaneni PV","year":"2021","unstructured":"Mummaneni PV, Bydon M, Knightly JJ,  Identifying patients at risk for nonroutine discharge after surgery for cervical myelopathy: an analysis from the Quality Outcomes Database. 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Neurosurg Focus. 2020;48(5):E2."},{"issue":"1","key":"b15","series-title":"J Neurosurg Spine","first-page":"41","article-title":"Social risk factors predicting outcomes of cervical myelopathy surgery","volume":"37","author":"Rethorn ZD","year":"2022","unstructured":"Rethorn ZD, Cook CE, Park C,  Social risk factors predicting outcomes of cervical myelopathy surgery. J Neurosurg Spine. 2022;37(1):41\u201348."},{"key":"b16","series-title":"World Neurosurg","first-page":"e436","article-title":"Differences in patient-reported outcomes between anterior and posterior approaches for treatment of cervical spondylotic myelopathy: a Quality Outcomes Database analysis","volume":"160","author":"Wilkerson CG","year":"2022","unstructured":"Wilkerson CG, Sherrod BA, Alvi MA,  Differences in patient-reported outcomes between anterior and posterior approaches for treatment of cervical spondylotic myelopathy: a Quality Outcomes Database analysis. World Neurosurg. 2022;160:e436\u2013e441."},{"issue":"1","key":"b17","series-title":"J Neurosurg Spine","first-page":"21","article-title":"Clinical and radiographic parameters associated with best versus worst clinical outcomes in minimally invasive spinal deformity surgery","volume":"25","author":"Than KD","year":"2016","unstructured":"Than KD, Park P, Fu KM,  Clinical and radiographic parameters associated with best versus worst clinical outcomes in minimally invasive spinal deformity surgery. 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Eur Spine J. 2017;26(1):78\u201384."},{"issue":"11","key":"b19","series-title":"Spine (Phila Pa 1976)","first-page":"717","article-title":"Clinically Meaningful improvement following cervical spine surgery: 30% reduction versus absolute point-change MCID values","volume":"46","author":"Khan I","year":"2021","unstructured":"Khan I, Pennings JS, Devin CJ,  Clinically Meaningful improvement following cervical spine surgery: 30% reduction versus absolute point-change MCID values. 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J Neurosurg Spine. 2022;37(4):547\u2013555."},{"issue":"5","key":"b21","series-title":"Eur Spine J","first-page":"1234","article-title":"Minimum clinically important difference in outcome scores among patients undergoing cervical laminoplasty","volume":"28","author":"Kato S","year":"2019","unstructured":"Kato S, Oshima Y, Matsubayashi Y, Taniguchi Y, Tanaka S, Takeshita K. Minimum clinically important difference in outcome scores among patients undergoing cervical laminoplasty. Eur Spine J. 2019;28(5):1234\u20131241."},{"issue":"21","key":"b22","series-title":"Spine (Phila Pa 1976)","first-page":"1653","article-title":"The minimum clinically important difference of the modified Japanese Orthopaedic Association scale in patients with degenerative cervical myelopathy","volume":"40","author":"Tetreault L","year":"2015","unstructured":"Tetreault L, Nouri A, Kopjar B, C\u00f4t\u00e9 P, Fehlings MG. The minimum clinically important difference of the modified Japanese Orthopaedic Association scale in patients with degenerative cervical myelopathy. Spine (Phila Pa 1976). 2015;40(21):1653-1659."},{"issue":"3","key":"b23","series-title":"PLoS One","first-page":"e0264954","article-title":"Clinical improvement after surgery for degenerative cervical myelopathy; a comparison of Patient-Reported Outcome Measures during 12-month follow-up","volume":"17","author":"Mj\u00e5set C","year":"2022","unstructured":"Mj\u00e5set C, Zwart JA, Kolstad F, Solberg T, Grotle M. Clinical improvement after surgery for degenerative cervical myelopathy; a comparison of Patient-Reported Outcome Measures during 12-month follow-up. 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J Bone Joint Surg Am. 2017;99(12):1013\u20131021."},{"issue":"1","key":"b26","series-title":"Neurosurg Focus","first-page":"E1","article-title":"Delayed diagnosis of cervical spondylotic myelopathy by primary care physicians","volume":"35","author":"Behrbalk E","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(1):E1."},{"issue":"5","key":"b27","series-title":"BMJ Open","first-page":"e027000","article-title":"Route to diagnosis of degenerative cervical myelopathy in a UK healthcare system: a retrospective cohort study","volume":"9","author":"Hilton B","year":"2019","unstructured":"Hilton B, Tempest-Mitchell J, Davies B, Kotter M. Route to diagnosis of degenerative cervical myelopathy in a UK healthcare system: a retrospective cohort study. 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J Neurosurg Spine. 2009;11(2):112\u2013118."},{"issue":"3","key":"b33","series-title":"Orthop Clin North Am","first-page":"255","article-title":"Degenerative disorders of the lumbar and cervical spine","volume":"36","author":"Roh JS","year":"2005","unstructured":"Roh JS, Teng AL, Yoo JU, Davis J, Furey C, Bohlman HH. Degenerative disorders of the lumbar and cervical spine. Orthop Clin North Am. 2005;36(3):255\u2013262."},{"issue":"5","key":"b34","series-title":"Int J Spine Surg","first-page":"629","article-title":"Arm pain versus neck pain: a novel ratio as a predictor of post-operative clinical outcomes in cervical radiculopathy patients","volume":"12","author":"Passias PG","year":"2018","unstructured":"Passias PG, Hasan S, Radcliff K,  Arm pain versus neck pain: a novel ratio as a predictor of post-operative clinical outcomes in cervical radiculopathy patients. 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