Outcome Measures for Cervical Spondylotic Myelopathy and Degenerative Cervical Myelopathy

Study Design: Review. Objective: To provide an overview of outcome measures used to evaluate cervical spondylotic myelopathy (CSM) and degenerative cervical myelopathy (DCM), emphasizing their diagnostic utility, prognostic value, and limitations. Summary of Background Data: DCM and CSM lead to spinal cord compression and neurological impairment. Effective outcome measures are essential for disease monitoring and clinical decision-making. Methods: A comprehensive literature review was conducted. Results: The modified Japanese Orthopaedic Association scale (mJOA) and Nurick grading remain standard provider assessments for DCM and CSM but have limitations. The patient-derived mJOA (P-mJOA) is a patient-reported outcome measure (PROM) similar to the European Myelopathy Score (EMS), whereas PROMs such as the Neck Disability Index, Short Form-36, and EuroQol-5D lack disease specificity. Advances in imaging, including diffusion tensor imaging (DTI) and diffusion basis spectrum imaging (DBSI), electrophysiological assessments, and wearable sensors, may enhance diagnostic precision in the future. Conclusions: Integrating subjective and objective outcome measures can enhance DCM/CSM assessment. A multimodal approach may improve diagnosis, prognostication, and guide treatment recommendations through traditional clinical assessments, evolving patient-reported outcome measures, advanced imaging techniques, and wearable sensor data. Large data sets made possible by these advancements can leverage the power of predictive analytics and artificial intelligence.