{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:04:33Z","timestamp":1780131873797,"version":"3.54.0"},"reference-count":92,"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 objective of this study was to determine the time frame of clinical improvement in patient-reported outcomes (PROs) following surgical decompression for cervical spondylotic myelopathy (CSM). Based on previously published 12-month data from this group, the authors hypothesized that the average time to minimal clinically important difference (MCID) improvement would primarily occur by 3 months postoperatively regardless of preoperative myelopathy severity. They also hypothesized that there would be minimal additional improvement between 3 months and 5 years after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This was a post hoc analysis of prospectively collected data from the 14-site Spine CORe\u2122 study group of the Quality Outcomes Database (QOD). Patients were stratified according to myelopathy severity using the modified Japanese Orthopaedic Association (mJOA) myelopathy scale into mild (mJOA score 15\u201317), moderate (mJOA score 12\u201314) or severe (mJOA score &lt; 12). PRO measures included the Neck Disability Index (NDI), numeric rating scale (NRS) for neck and arm pain, and EQ-5D for quality-adjusted life years. PROs were recorded at baseline, 3-month, 12-month, 2-year, and 5-year intervals. MCID thresholds were calculated using previously validated methods in this cohort. Time to meet the MCID cutoff and the proportion of patients achieving MCID at each time point were determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 1085 patients (with \u2265 80% follow-up at 60 months for all PRO measures [PROMs]) were enrolled. Patients with more severe myelopathy had worse baseline comorbidities (e.g., BMI, American Society of Anesthesiology class, ambulation dependence) and lower PRO scores. Average PROs met the MCID threshold in each category at 3 months postoperatively, regardless of baseline myelopathy severity. Of the patients with complete 5-year follow-up data, the majority achieved the MCID cutoff threshold for PROMs at 3 months (50%\u201373%, depending on the PROM). A minority of patients went on to meet the MCID for PROMs at 12 months (12%\u201321%), 2 years (4%\u20138%), and 5 years (1%\u20136%). Between 4% and 25% of patients never achieved MCID cutoffs at any time point.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>On average, patients achieved clinically meaningful improvement in PROs at 3 months postoperatively, regardless of preoperative severity. While the majority (50%\u201373%, depending on the PROM) reached MCID within 3 months, an additional 12%\u201321% improved by 12 months, 4%\u20138% by 2 years, and only 1%\u20136% by 5 years; 4%\u201325% never reach the MCID. This 5-year follow-up study clarifies the timeline of clinical improvement after surgery for CSM and provides a useful tool for both surgeon planning and patient counseling.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.12.focus25943","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:31:29Z","timestamp":1777635089000},"page":"E11","source":"Crossref","is-referenced-by-count":0,"title":["What is the average time frame of clinically meaningful improvement in surgical decompression for cervical spondylotic myelopathy? A Spine CORe\u2122 analysis of QOD data: 5-year follow-up"],"prefix":"10.3171","volume":"60","author":[{"given":"Connor","family":"Berlin","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izza","family":"Tahir","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Cassimatis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maliya","family":"Delawan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gracie","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Setaro","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen V.","family":"Mummaneni","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew K.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Columbia University, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Columbia University, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai-Ming","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medicine, 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":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oren N.","family":"Gottfried","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony L.","family":"Asher","sequence":"additional","affiliation":[{"name":"Carolina Neurosurgery & Spine Associates, Carolinas Medical Center, Charlotte, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul K.","family":"Kim","sequence":"additional","affiliation":[{"name":"Carolina Neurosurgery & Spine Associates, Carolinas Medical Center, Charlotte, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric A.","family":"Potts","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent J.","family":"Alentado","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin T.","family":"Foley","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Tennessee Health Science Center, Semmes Murphey Clinic, 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":"Michael S.","family":"Virk","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medicine, New York, New York;"}],"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":"Maxim Spine, Morristown, New Jersey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Tennessee Health Science Center, Semmes Murphey Clinic, Memphis, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheerag D.","family":"Upadhyaya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of North Carolina, Chapel Hill, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis M.","family":"Tumial\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay D.","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan S.","family":"Uribe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona;"}],"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":"Timothy J.","family":"Yee","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Michigan Health, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Bydon","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Po","family":"Yen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"Suppl 2","key":"b1","series-title":"Eur Spine J","first-page":"236","article-title":"Predictors of outcome in patients with degenerative cervical spondylotic myelopathy undergoing surgical treatment: results of a systematic review","volume":"24","author":"Tetreault LA","year":"2015","unstructured":"Tetreault LA, Karpova A, Fehlings MG. 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