TY - JOUR
T1 - The modified Japanese Orthopaedic Association scale
T2 - establishing criteria for mild, moderate and severe impairment in patients with degenerative cervical myelopathy
AU - Tetreault, Lindsay
AU - Kopjar, Branko
AU - Nouri, Aria
AU - Arnold, Paul
AU - Barbagallo, Giuseppe
AU - Bartels, Ronald
AU - Qiang, Zhou
AU - Singh, Anoushka
AU - Zileli, Mehmet
AU - Vaccaro, Alexander
AU - Fehlings, Michael G.
N1 - Publisher Copyright:
© 2016, Springer-Verlag Berlin Heidelberg.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Purpose: We aimed to determine cut-offs between mild, moderate and severe myelopathy on the modified Japanese Orthopedic Association (mJOA) score. Methods: Between December 2005 and January 2011, 757 patients with clinically diagnosed DCM were enrolled in the prospective AOSpine North America (n = 278) or International (n = 479) study at 26 sites. Functional status and quality of life were evaluated at baseline using a variety of outcome measures. Using the Nurick score as an anchor, receiver operating curve (ROC) analysis was conducted to determine cut-offs between mild, moderate and severe disease. The validity of the identified cut-offs was evaluated by examining whether patients in different severity groups differed in terms of impairment, disability, quality of life and number of signs and symptoms. Results: A mJOA of 14 was determined to be the cut-off between mild and moderate myelopathy and a mJOA of 11 was the cut-off score between moderate and severe disease. Patients in the severe myelopathy group (n = 254) had significantly reduced quality of life and functional status and a greater number of signs and symptoms compared to patients classified as mild (n = 190) or moderate (n = 296). Conclusions: Mild myelopathy can be defined as mJOA from 15 to 17, moderate as mJOA from 12 to 14 and severe as mJOA from 0 to 11. These categories should be adopted worldwide to standardize clinical assessment of DCM.
AB - Purpose: We aimed to determine cut-offs between mild, moderate and severe myelopathy on the modified Japanese Orthopedic Association (mJOA) score. Methods: Between December 2005 and January 2011, 757 patients with clinically diagnosed DCM were enrolled in the prospective AOSpine North America (n = 278) or International (n = 479) study at 26 sites. Functional status and quality of life were evaluated at baseline using a variety of outcome measures. Using the Nurick score as an anchor, receiver operating curve (ROC) analysis was conducted to determine cut-offs between mild, moderate and severe disease. The validity of the identified cut-offs was evaluated by examining whether patients in different severity groups differed in terms of impairment, disability, quality of life and number of signs and symptoms. Results: A mJOA of 14 was determined to be the cut-off between mild and moderate myelopathy and a mJOA of 11 was the cut-off score between moderate and severe disease. Patients in the severe myelopathy group (n = 254) had significantly reduced quality of life and functional status and a greater number of signs and symptoms compared to patients classified as mild (n = 190) or moderate (n = 296). Conclusions: Mild myelopathy can be defined as mJOA from 15 to 17, moderate as mJOA from 12 to 14 and severe as mJOA from 0 to 11. These categories should be adopted worldwide to standardize clinical assessment of DCM.
KW - Defining disease severity
KW - Degenerative cervical myelopathy
KW - Functional impairment
KW - Measurement
KW - Modified Japanese Orthopaedic Association scale
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U2 - 10.1007/s00586-016-4660-8
DO - 10.1007/s00586-016-4660-8
M3 - Article
C2 - 27342612
AN - SCOPUS:84976330175
SN - 0940-6719
VL - 26
SP - 78
EP - 84
JO - European Spine Journal
JF - European Spine Journal
IS - 1
ER -