{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:03:02Z","timestamp":1787025782326,"version":"build-2736575974"},"reference-count":98,"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>Minimal clinically important difference (MCID) thresholds are widely used to evaluate outcomes after surgery for cervical spondylotic myelopathy (CSM), but they may not fully reflect patient satisfaction. The authors hypothesized that discordance exists between MCID achievement in Neck Disability Index (NDI) score and satisfaction at long-term follow-up in a minority of patients after surgery for CSM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The 14-site Spine CORe\u2122 study group performed a post hoc analysis of their prospectively collected data from the Quality Outcomes Database, which included 1085 patients who underwent surgery for CSM. Patients with complete baseline and 5-year NDI scores as well as 5-year satisfaction data were included. Satisfaction was assessed using the North American Spine Society (NASS) satisfaction index, and the MCID was defined for the NDI score. Baseline characteristics and patient-reported outcomes were compared between satisfied and dissatisfied patients within the cohort who met the MCID for NDI score. Multivariate logistic regression identified predictors of dissatisfaction despite the MCID.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In total, 1085 patients underwent surgery for CSM. The 5-year follow-up rate was 82% (106 died within 5 years, and 782 had both 5-year satisfaction and NDI data). At 5 years postoperatively, 497 patients (63.6%) achieved the MCID in NDI score. Among MCID achievers, 463 (93%) were satisfied and 34 (7%) were not satisfied. On univariate analysis, of those who met the MCID, dissatisfied patients were more likely to be current smokers (32.4% vs 15.8%, p = 0.029) and less likely to participate in outside activities (58.8% vs 85.1%, p &lt; 0.001). They also presented with greater baseline disability (NDI score: 47.9 \u00b1 18.2 vs 41.1 \u00b1 19.5, p = 0.021), lower quality of life (EQ-5D score: 0.50 \u00b1 0.19 vs 0.58 \u00b1 0.22, p = 0.029), and lower preoperative functional status (mJOA score: 11.2 \u00b1 2.8 vs 12.3 \u00b1 2.7, p = 0.025) compared with satisfied patients. On multivariate analysis, of those who met the MCID, smoking showed a trend toward higher odds of dissatisfaction (OR 2.12, p = 0.065), while participation in outside activities was protective (OR 0.28, p &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In this study, only 7% of patients were dissatisfied despite achieving the MCID for NDI score. Participation in outside activities was independently associated with greater satisfaction, whereas smoking showed a trend toward increased dissatisfaction despite meeting the MCID for NDI score. The MCID and satisfaction capture distinct yet complementary aspects of recovery and should be jointly considered during preoperative counseling and postoperative outcome assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.12.focus25946","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:31:23Z","timestamp":1777635083000},"page":"E13","source":"Crossref","is-referenced-by-count":1,"title":["Is there discordance between achieving the minimal clinically important difference in Neck Disability Index score and patient satisfaction after surgery for cervical spondylotic myelopathy? A Spine CORe\u2122 5-year analysis of QOD data"],"prefix":"10.3171","volume":"60","author":[{"given":"Nima","family":"Alan","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham","family":"Dada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Elguindy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Francisco, California;"}],"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":"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":"Vincent J.","family":"Alentado","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":"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":"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":"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 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;"}],"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"}]},{"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 Surgery, University of Michigan, Ann Arbor, Michigan; and"}],"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 Neurosurgery, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"12","key":"b1","series-title":"Spine (Phila Pa 1976)","first-page":"E675","article-title":"Degenerative cervical myelopathy: epidemiology, genetics, and 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