{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:04:50Z","timestamp":1780131890014,"version":"3.54.0"},"reference-count":50,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The purpose of this study was to evaluate patients undergoing surgery for cervical spondylotic myelopathy who presented with severe arm pain to determine which factors are associated with persistent and improved postoperative arm pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Of the patients with CSM included from 14 Spine CORe\u2122 study group sites participating in the Quality Outcomes Database, those who presented with severe arm pain preoperatively (numeric rating scale [NRS] scores 7\u201310) were selected for analysis. Within this subset, patients who reported persistent severe arm pain (NRS scores 7\u201310) postoperatively were compared with patients who had moderate and improved\/mild arm pain (NRS scores 4\u20136 and 0\u20133, respectively) postoperatively. NRS scores for arm pain were recorded at baseline and postoperatively at 3 months, 1 year, 2 years, and 5 years. Demographics, comorbidities, and patient-reported outcome measures (Neck Disability Index [NDI], quality-adjusted life years [QALY], modified Japanese Orthopaedic Association [mJOA] scale, and EuroQol visual analog scale [EQ-VAS]) were evaluated. These factors were compared between patients with persistent and those with improved arm pain at the 5-year follow-up using the Wilcoxon rank-sum test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of 1085 patients with CSM, 458 reported severe arm pain (NRS scores 7\u201310) preoperatively. Of these, 60.7% of patients reported mild arm pain (NRS scores 0\u20133), 20.4% reported moderate arm pain (NRS scores 4\u20136), and 18.9% reported persistent severe arm pain (NRS scores 7\u201310) at the 5-year follow-up. Patients with persistent severe pain had significantly higher NDI scores (p = 0.001) and lower mJOA (p = 0.04), QALY (p = 0.02), and EQ-VAS (p &lt; 0.00001) scores at baseline. Patients with mild\/improved arm pain were significantly more likely to have postgraduate education (p = 0.04). Patients with early postoperative improvement in arm pain (at 3 months, p &lt; 0.0001) had sustained improvement through the 5-year postoperative time point. However, patients with persistent severe pain at 5 years had consistently higher pain at all postoperative time points (3 months, 1 year, and 2 years), which significantly worsened between the 2- and 5-year time points (mean NRS scores from 4.8 to 8, p &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Among patients who underwent surgery for CSM who presented with severe radicular arm pain (NRS scores 7\u201310), 81.1% reported improvement (NRS scores 0\u20136), and 18.9% reported persistent severe arm pain 5 years after surgery. Persistent arm pain was associated with increased preoperative disability (mJOA, NDI, QALY, and EQ-VAS), while postgraduate education was associated with improved arm pain. Patients with early postoperative improvement in arm pain demonstrated a durable result through 5 years of follow-up, which could improve further. Conversely, those with severe postoperative arm pain had persistent pain at 2 years, which further deteriorated between 2 and 5 years, thus warranting careful long-term surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.12.focus25935","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:31:31Z","timestamp":1777635091000},"page":"E5","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors for persistent arm pain 5 years after surgery for cervical spondylotic myelopathy: a Spine CORe\u2122 analysis of QOD data"],"prefix":"10.3171","volume":"60","author":[{"given":"Natasha","family":"Kharas","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Weill Cornell Medical Center, NewYork-Presbyterian, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Winston","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Weill Cornell Medical Center, NewYork-Presbyterian, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica F.","family":"Bisson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Bydon","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Chicago, Illinois;"}],"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":"Paul K.","family":"Kim","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":"Vincent J.","family":"Alentado","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 Neurosurgery, University of Miami, Florida;"}],"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":"John J.","family":"Knightly","sequence":"additional","affiliation":[{"name":"Maxim Spine, 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 Neurosurgery, University of Tennessee, Semmes Murphey Neurologic and Spine Institute, Memphis, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheerag D.","family":"Upadhyaya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of North Carolina at Chapel Hill, North Carolina;"},{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew K.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons, The Och Spine Hospital at NewYork-Presbyterian, New York, New York;"}],"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":"Dean","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons, The Och Spine Hospital at NewYork-Presbyterian, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan S.","family":"Uribe","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":"Timothy J.","family":"Yee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regis W.","family":"Haid","sequence":"additional","affiliation":[{"name":"Atlanta Brain and Spine Care, Atlanta, Georgia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen V.","family":"Mummaneni","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai-Ming","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Weill Cornell Medical Center, NewYork-Presbyterian, 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, NewYork-Presbyterian, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"Nat Rev Neurol","first-page":"108","article-title":"Degenerative cervical myelopathy - update and future directions","volume":"16","author":"Badhiwala JH","year":"2020","unstructured":"Badhiwala JH, Ahuja CS, Akbar MA,  Degenerative cervical myelopathy - update and future directions. Nat Rev Neurol. 2020;16(2):108\u2013124. doi:10.1038\/s41582-019-0303-0"},{"issue":"12","key":"b2","series-title":"Spine (Phila Pa 1976)","first-page":"E675","article-title":"Degenerative cervical myelopathy: epidemiology, genetics, and pathogenesis","volume":"40","author":"Nouri A","year":"2015","unstructured":"Nouri A, Tetreault L, Singh A, Karadimas SK, Fehlings MG. Degenerative cervical myelopathy: epidemiology, genetics, and pathogenesis. Spine (Phila Pa 1976). 2015;40(12):E675\u2013693. doi:10.1097\/BRS.0000000000000913"},{"issue":"1","key":"b3","series-title":"J Neurol","first-page":"311","article-title":"Most degenerative cervical myelopathy remains undiagnosed, particularly amongst the elderly: modelling the prevalence of degenerative cervical myelopathy in the United Kingdom","volume":"270","author":"Grodzinski B","year":"2023","unstructured":"Grodzinski B, Stubbs DJ, Davies BM. Most degenerative cervical myelopathy remains undiagnosed, particularly amongst the elderly: modelling the prevalence of degenerative cervical myelopathy in the United Kingdom. J Neurol. 2023;270(1):311\u2013319. doi:10.1007\/s00415-022-11349-8"},{"issue":"24","key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"1908","article-title":"Prevalence and imaging characteristics of nonmyelopathic and myelopathic spondylotic cervical cord compression","volume":"41","author":"Kovalova I","year":"2016","unstructured":"Kovalova I, Kerkovsky M, Kadanka Z,  Prevalence and imaging characteristics of nonmyelopathic and myelopathic spondylotic cervical cord compression. Spine (Phila Pa 1976). 2016;41(24):1908\u20131916. doi:10.1097\/BRS.0000000000001842"},{"issue":"6","key":"b5","series-title":"Spine J","first-page":"469","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 LY","year":"2010","unstructured":"Carreon LY, Glassman SD, Campbell MJ, Anderson PA. 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. Spine J. 2010;10(6):469\u2013474. doi:10.1016\/j.spinee.2010.02.007"},{"issue":"21","key":"b6","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\u20131659. doi:10.1097\/BRS.0000000000001127"},{"issue":"18","key":"b7","series-title":"J Bone Joint Surg Am","first-page":"1651","article-title":"Efficacy and safety of surgical decompression in patients with cervical spondylotic myelopathy: results of the AOSpine North America prospective multi-center study","volume":"95","author":"Fehlings MG","year":"2013","unstructured":"Fehlings MG, Wilson JR, Kopjar B,  Efficacy and safety of surgical decompression in patients with cervical spondylotic myelopathy: results of the AOSpine North America prospective multi-center study. J Bone Joint Surg Am. 2013;95(18):1651\u20131658. doi:10.2106\/JBJS.L.00589"},{"issue":"17","key":"b8","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. Spine (Phila Pa 1976). 2015;40(17):1322\u20131328. doi:10.1097\/BRS.0000000000000988"},{"issue":"6","key":"b9","series-title":"Neurosurg Focus","first-page":"E5","article-title":"Which supervised machine learning algorithm can best predict achievement of minimum clinically important difference in neck pain after surgery in patients with cervical myelopathy? A QOD study","volume":"54","author":"Park C","year":"2023","unstructured":"Park C, Mummaneni PV, Gottfried ON,  Which supervised machine learning algorithm can best predict achievement of minimum clinically important difference in neck pain after surgery in patients with cervical myelopathy? A QOD study. Neurosurg Focus. 2023;54(6):E5. doi:10.3171\/2023.3.FOCUS2372"},{"issue":"7","key":"b10","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. doi:10.1177\/2192568220986143"},{"issue":"10","key":"b11","series-title":"BMJ Open","first-page":"e031486","article-title":"Recovery priorities in degenerative cervical myelopathy: a cross-sectional survey of an international, online community of patients","volume":"9","author":"Davies B","year":"2019","unstructured":"Davies B, Mowforth O, Sadler I,  Recovery priorities in degenerative cervical myelopathy: a cross-sectional survey of an international, online community of patients. BMJ Open. 2019;9(10):e031486. doi:10.1136\/bmjopen-2019-031486"},{"issue":"5","key":"b12","series-title":"J Neurosurg Spine","first-page":"758","article-title":"Determining the time frame of maximum clinical improvement in surgical decompression for cervical spondylotic myelopathy when stratified by preoperative myelopathy severity: a cervical Quality Outcomes Database study","volume":"37","author":"Berlin C","year":"2022","unstructured":"Berlin C, Marino AC, Mummaneni PV,  Determining the time frame of maximum clinical improvement in surgical decompression for cervical spondylotic myelopathy when stratified by preoperative myelopathy severity: a cervical Quality Outcomes Database study. J Neurosurg Spine. 2022;37(5):758\u2013766. doi:10.3171\/2022.5.SPINE211425"},{"issue":"10","key":"b13","series-title":"JAMA","first-page":"942","article-title":"Effect of ventral vs dorsal spinal surgery on patient-reported physical functioning in patients with cervical spondylotic myelopathy: a randomized clinical trial","volume":"325","author":"Ghogawala Z","year":"2021","unstructured":"Ghogawala Z, Terrin N, Dunbar MR,  Effect of ventral vs dorsal spinal surgery on patient-reported physical functioning in patients with cervical spondylotic myelopathy: a randomized clinical trial. JAMA. 2021;325(10):942\u2013951. doi:10.1001\/jama.2021.1233"},{"issue":"6","key":"b14","series-title":"Neurosurgery","first-page":"763","article-title":"Trajectory of improvement in myelopathic symptoms from 3 to 12 months following surgery for degenerative cervical myelopathy","volume":"86","author":"Khan I","year":"2020","unstructured":"Khan I, Archer KR, Wanner JP,  Trajectory of improvement in myelopathic symptoms from 3 to 12 months following surgery for degenerative cervical myelopathy. Neurosurgery. 2020;86(6):763\u2013768. doi:10.1093\/neuros\/nyz325"},{"issue":"5","key":"b15","series-title":"J Neurosurg Spine","first-page":"671","article-title":"Cervical laminoplasty versus laminectomy and posterior cervical fusion for cervical myelopathy: propensity-matched analysis of 24-month outcomes from the Quality Outcomes Database","volume":"39","author":"Yang E","year":"2023","unstructured":"Yang E, Mummaneni PV, Chou D,  Cervical laminoplasty versus laminectomy and posterior cervical fusion for cervical myelopathy: propensity-matched analysis of 24-month outcomes from the Quality Outcomes Database. J Neurosurg Spine. 2023;39(5):671\u2013681. doi:10.3171\/2023.6.SPINE23345"},{"issue":"4","key":"b16","series-title":"J Neurosurg Spine","first-page":"453","article-title":"What predicts the best 24-month outcomes following surgery for cervical spondylotic myelopathy? A QOD prospective registry study","volume":"40","author":"Chan AK","year":"2024","unstructured":"Chan AK, Park C, Shaffrey CI,  What predicts the best 24-month outcomes following surgery for cervical spondylotic myelopathy? A QOD prospective registry study. J Neurosurg Spine. 2024;40(4):453\u2013464. doi:10.3171\/2023.11.SPINE23222"},{"issue":"2","key":"b17","series-title":"Spine (Phila Pa 1976)","first-page":"113","article-title":"Patient-reported data as predictors of surgical outcome in patients with degenerative cervical myelopathy: analysis of a national multicenter dataset","volume":"48","author":"Gerdhem L","year":"2023","unstructured":"Gerdhem L, Charalampidis A, Gerdhem P. Patient-reported data as predictors of surgical outcome in patients with degenerative cervical myelopathy: analysis of a national multicenter dataset. Spine (Phila Pa 1976). 2023;48(2):113\u2013119. doi:10.1097\/BRS.0000000000004469"},{"issue":"4","key":"b18","series-title":"J Neurosurg Spine","first-page":"500","article-title":"Patient-reported outcome trajectories the first 24 months after surgery for cervical spondylotic myelopathy: a Quality Outcomes Database study","volume":"42","author":"Zeitouni D","year":"2025","unstructured":"Zeitouni D, Johnson SE, Ibrahim S,  Patient-reported outcome trajectories the first 24 months after surgery for cervical spondylotic myelopathy: a Quality Outcomes Database study. J Neurosurg Spine. 2025;42(4):500\u2013508. doi:10.3171\/2024.9.SPINE24351"},{"issue":"3","key":"b19","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. PLoS One. 2022;17(3):e0264954. doi:10.1371\/journal.pone.0264954"},{"issue":"5","key":"b20","series-title":"Spine (Phila Pa 1976)","first-page":"321","article-title":"Clinical improvements in myelopathy result in improved patient-reported outcomes following anterior cervical discectomy and fusion","volume":"48","author":"Lambrechts MJ","year":"2023","unstructured":"Lambrechts MJ, Toci GR, Karamian BA,  Clinical improvements in myelopathy result in improved patient-reported outcomes following anterior cervical discectomy and fusion. Spine (Phila Pa 1976). 2023;48(5):321\u2013329. doi:10.1097\/BRS.0000000000004518"},{"issue":"16","key":"b21","series-title":"Spine (Phila Pa 1976)","first-page":"1102","article-title":"Outcomes of surgical decompression in patients with very severe degenerative cervical myelopathy","volume":"43","author":"Kopjar B","year":"2018","unstructured":"Kopjar B, Bohm PE, Arnold JH, Fehlings MG, Tetreault LA, Arnold PM. Outcomes of surgical decompression in patients with very severe degenerative cervical myelopathy. Spine (Phila Pa 1976). 2018;43(16):1102\u20131109. doi:10.1097\/BRS.0000000000002602"},{"issue":"10","key":"b22","series-title":"Spine (Phila Pa 1976)","first-page":"649","article-title":"Severity of preoperative myelopathy symptoms affects patient-reported outcomes, satisfaction, and return to work after anterior cervical discectomy and fusion for degenerative cervical myelopathy","volume":"45","author":"Goh GSH","year":"2020","unstructured":"Goh GSH, Liow MHL, Ling ZM,  Severity of preoperative myelopathy symptoms affects patient-reported outcomes, satisfaction, and return to work after anterior cervical discectomy and fusion for degenerative cervical myelopathy. Spine (Phila Pa 1976). 2020;45(10):649\u2013656. doi:10.1097\/BRS.0000000000003354"},{"issue":"5","key":"b23","series-title":"Neurosurgery","first-page":"844","article-title":"Effectiveness of surgical decompression in patients with degenerative cervical myelopathy: results of the Canadian Prospective Multicenter Study","volume":"89","author":"Karim SM","year":"2021","unstructured":"Karim SM, Cadotte DW, Wilson JR,  Effectiveness of surgical decompression in patients with degenerative cervical myelopathy: results of the Canadian Prospective Multicenter Study. Neurosurgery. 2021;89(5):844\u2013851. doi:10.1093\/neuros\/nyab295"},{"issue":"4","key":"b24","series-title":"N Engl J Med","first-page":"392","article-title":"Cervical radiculopathy","volume":"353","author":"Carette S","year":"2005","unstructured":"Carette S, Fehlings MG. Cervical radiculopathy. N Engl J Med. 2005;353(4):392\u2013399. doi:10.1056\/NEJMcp043887"},{"issue":"8","key":"b25","series-title":"Spine J","first-page":"1781","article-title":"The course and prognostic factors of symptomatic cervical disc herniation with radiculopathy: a systematic review of the literature","volume":"14","author":"Wong JJ","year":"2014","unstructured":"Wong JJ, C\u00f4t\u00e9 P, Quesnele JJ, Stern PJ, Mior SA. The course and prognostic factors of symptomatic cervical disc herniation with radiculopathy: a systematic review of the literature. Spine J. 2014;14(8):1781\u20131789. doi:10.1016\/j.spinee.2014.02.032"},{"issue":"2","key":"b1","series-title":"Nat Rev Neurol","first-page":"108","article-title":"Degenerative cervical myelopathy - update and future directions","volume":"16","author":"Badhiwala JH","year":"2020","unstructured":"Badhiwala JH, Ahuja CS, Akbar MA,  Degenerative cervical myelopathy - update and future directions. Nat Rev Neurol. 2020;16(2):108\u2013124. doi:10.1038\/s41582-019-0303-0"},{"issue":"12","key":"b2","series-title":"Spine (Phila Pa 1976)","first-page":"E675","article-title":"Degenerative cervical myelopathy: epidemiology, genetics, and pathogenesis","volume":"40","author":"Nouri A","year":"2015","unstructured":"Nouri A, Tetreault L, Singh A, Karadimas SK, Fehlings MG. Degenerative cervical myelopathy: epidemiology, genetics, and pathogenesis. Spine (Phila Pa 1976). 2015;40(12):E675\u2013693. doi:10.1097\/BRS.0000000000000913"},{"issue":"1","key":"b3","series-title":"J Neurol","first-page":"311","article-title":"Most degenerative cervical myelopathy remains undiagnosed, particularly amongst the elderly: modelling the prevalence of degenerative cervical myelopathy in the United Kingdom","volume":"270","author":"Grodzinski B","year":"2023","unstructured":"Grodzinski B, Stubbs DJ, Davies BM. Most degenerative cervical myelopathy remains undiagnosed, particularly amongst the elderly: modelling the prevalence of degenerative cervical myelopathy in the United Kingdom. J Neurol. 2023;270(1):311\u2013319. doi:10.1007\/s00415-022-11349-8"},{"issue":"24","key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"1908","article-title":"Prevalence and imaging characteristics of nonmyelopathic and myelopathic spondylotic cervical cord compression","volume":"41","author":"Kovalova I","year":"2016","unstructured":"Kovalova I, Kerkovsky M, Kadanka Z,  Prevalence and imaging characteristics of nonmyelopathic and myelopathic spondylotic cervical cord compression. Spine (Phila Pa 1976). 2016;41(24):1908\u20131916. doi:10.1097\/BRS.0000000000001842"},{"issue":"6","key":"b5","series-title":"Spine J","first-page":"469","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 LY","year":"2010","unstructured":"Carreon LY, Glassman SD, Campbell MJ, Anderson PA. 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. 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