{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T14:20:02Z","timestamp":1768918802181,"version":"3.49.0"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Myelopathy in the cervical spine can present with diverse symptoms, many of which can be debilitating for patients. Patients with radiculopathy symptoms demonstrate added complexity because of the overlapping symptoms and treatment considerations. The authors sought to assess outcomes in patients with myelopathy presenting with or without concurrent radiculopathy.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The Quality Outcomes Database, a prospectively collected multi-institutional database, was used to analyze demographic, clinical, and surgical variables of patients presenting with myelopathy or myeloradiculopathy as a result of degenerative pathology. Outcome measures included arm (VAS-arm) and neck (VAS-neck) visual analog scale (VAS) scores, modified Japanese Orthopaedic Association (mJOA) scale score, EuroQol VAS (EQ-VAS) score, and Neck Disability Index (NDI) at 3, 12, and 24 months compared with baseline.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>A total of 1015 patients were included in the study: 289 patients with myelopathy alone (M<jats:sub>0<\/jats:sub>), 239 with myeloradiculopathy but no arm pain (MR<jats:sub>AP\u2212<\/jats:sub>), and 487 patients with myeloradiculopathy and arm pain (MR<jats:sub>AP+<\/jats:sub>). M<jats:sub>0<\/jats:sub> patients were older than the myeloradiculopathy cohorts combined (M<jats:sub>0<\/jats:sub> 64.2 vs MR<jats:sub>AP\u2212 <\/jats:sub>+ MR<jats:sub>AP+<\/jats:sub> 59.5 years, p &lt; 0.001), whereas MR<jats:sub>AP+<\/jats:sub> patients had higher BMI and a greater incidence of current smoking compared with the other cohorts. There were more anterior approaches used in in MR<jats:sub>AP+<\/jats:sub> patients and more posterior approaches used in M<jats:sub>0<\/jats:sub> patients. In severely myelopathic patients (mJOA scale score \u2264 10), posterior approaches were used more often for M<jats:sub>0<\/jats:sub> (p &lt; 0.0001) and MR<jats:sub>AP+<\/jats:sub> (p &lt; 0.0001) patients. Patients with myelopathy and myeloradiculopathy both exhibited significant improvement at 1 and 2 years across all outcome domains. The amount of improvement did not vary based on surgical approach. In comparing cohort outcomes, postoperative outcome differences were associated with patient-reported scores at baseline.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Patients with myelopathy and those with myeloradiculopathy demonstrated significant and similar improvement in arm and neck pain scores, myelopathy, disability, and quality of life at 3 months that was sustained at 1- and 2-year follow-up intervals. More radicular symptoms and arm pain increased the likelihood of a surgeon choosing an anterior approach, whereas more severe myelopathy increased the likelihood of approaching posteriorly. Surgical approach itself was not an independent predictor of outcome.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.5.spine24170","type":"journal-article","created":{"date-parts":[[2024,9,7]],"date-time":"2024-09-07T01:54:51Z","timestamp":1725674091000},"page":"734-745","source":"Crossref","is-referenced-by-count":1,"title":["Comparative analysis of patient-reported outcomes in myelopathy and myeloradiculopathy: a Quality Outcomes Database study"],"prefix":"10.3171","volume":"41","author":[{"given":"Ken","family":"Porche","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica F.","family":"Bisson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon","family":"Sherrod","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Dru","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Semmes Murphey Neurologic and Spine Institute, University of Tennessee, Memphis, Tennessee;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew K.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Columbia University Irving Medical Center, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oren N.","family":"Gottfried","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad","family":"Bydon","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony L.","family":"Asher","sequence":"additional","affiliation":[{"name":"Neuroscience Institute, Carolina Neurosurgery & Spine Associates, Carolinas Healthcare System, Charlotte, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domagoj","family":"Coric","sequence":"additional","affiliation":[{"name":"Neuroscience Institute, Carolina Neurosurgery & Spine Associates, Carolinas Healthcare System, Charlotte, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric A.","family":"Potts","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Goodman Campbell Brain and Spine, Indianapolis, Indiana;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin T.","family":"Foley","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Semmes Murphey Neurologic and Spine Institute, University of Tennessee, Memphis, Tennessee;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai-Ming","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medical Center, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael S.","family":"Virk","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medical Center, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.","family":"Knightly","sequence":"additional","affiliation":[{"name":"Atlantic Neurosurgical Specialists, Morristown, New Jersey;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Meyer","sequence":"additional","affiliation":[{"name":"Atlantic Neurosurgical Specialists, Morristown, New Jersey;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheerag D.","family":"Upadhyaya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark E.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan S.","family":"Uribe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis M.","family":"Tumial\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay D.","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dean","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Columbia University Irving Medical Center, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regis W.","family":"Haid","sequence":"additional","affiliation":[{"name":"Atlanta Brain and Spine Care, Atlanta, Georgia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Praveen V.","family":"Mummaneni","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Semmes Murphey Neurologic and Spine Institute, University of Tennessee, Memphis, Tennessee;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"Asian Spine J","first-page":"710","article-title":"Degenerative cervical myelopathy: pathophysiology and current treatment strategies","volume":"14","author":"Choi 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Degenerative cervical myelopathy: pathophysiology and current treatment strategies. Asian Spine J. 2020;14(5):710\u2013720."},{"issue":"7","key":"b2","series-title":"Eur J Orthop Surg Traumatol","first-page":"889","article-title":"Cervical radiculopathy combined with cervical myelopathy: prevalence and characteristics","volume":"27","author":"Choi BW","year":"2017","unstructured":"Choi BW, Kim SS, Lee DH, Kim JW. Cervical radiculopathy combined with cervical myelopathy: prevalence and characteristics. Eur J Orthop Surg Traumatol. 2017;27(7):889\u2013893."},{"issue":"1-3","key":"b3","series-title":"Acta Neurochir (Wien)","first-page":"89","article-title":"A comparative study of the treatment of cervical spondylotic myeloradiculopathy. Experience with 50 cases treated by means of extensive laminectomy, foraminotomy, and excision of osteophytes during the past 10 years","volume":"61","author":"Epstein JA","year":"1982","unstructured":"Epstein JA, Janin Y, Carras R, Lavine LS. 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Eur Spine J. 2015;24(8):1621\u20131630."},{"issue":"1","key":"b15","series-title":"Int J Spine Surg","first-page":"88","article-title":"Anterior vs. posterior approach in multilevel cervical spondylotic myelopathy: a nationwide propensity-matched analysis of complications, outcomes, and narcotic use","volume":"16","author":"Nunna RS","year":"2022","unstructured":"Nunna RS, Khalid S, Chiu RG,  Anterior vs. posterior approach in multilevel cervical spondylotic myelopathy: a nationwide propensity-matched analysis of complications, outcomes, and narcotic use. 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Int J Spine Surg. 2023;17(3):418\u2013425."},{"issue":"3","key":"b19","series-title":"Neurosurgery","first-page":"628","article-title":"Anterior cervical discectomy and fusion versus microendoscopic posterior cervical foraminotomy for unilateral cervical radiculopathy: a 1-year cost-utility analysis","volume":"93","author":"Monk SH","year":"2023","unstructured":"Monk SH, Hani U, Pfortmiller D,  Anterior cervical discectomy and fusion versus microendoscopic posterior cervical foraminotomy for unilateral cervical radiculopathy: a 1-year cost-utility analysis. Neurosurgery. 2023;93(3):628\u2013635."},{"issue":"2","key":"b20","series-title":"Neurosurgery","first-page":"413","article-title":"Comparison of anterior cervical discectomy and fusion to posterior cervical foraminotomy for cervical radiculopathy: utilization, costs, and adverse events 2003 to 2014","volume":"84","author":"Witiw CD","year":"2019","unstructured":"Witiw CD, Smieliauskas F, O\u2019Toole JE, Fehlings MG, Fessler RG. Comparison of anterior cervical discectomy and fusion to posterior cervical foraminotomy for cervical radiculopathy: utilization, costs, and adverse events 2003 to 2014. Neurosurgery. 2019;84(2):413\u2013420."},{"issue":"7","key":"b21","series-title":"Global Spine J","first-page":"1434","article-title":"Moving beyond the neck and arm: the pain experience of people with degenerative cervical myelopathy who have pain","volume":"12","author":"Boerger T","year":"2022","unstructured":"Boerger T, Alsouhibani A, Mowforth O,  Moving beyond the neck and arm: the pain experience of people with degenerative cervical myelopathy who have pain. Global Spine J. 2022;12(7):1434\u20131442."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/6\/article-p734.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/6\/article-p734.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/6\/article-p734.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:20:45Z","timestamp":1733491245000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/6\/article-p734.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,1]]},"references-count":21,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2024.5.spine24170","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2024,12,1]]}}}