Myelopathy Scores

Because the operative and nonoperative management of cervical spine disorders has become increasingly prevalent, it is essential that appropriate functional outcomes measures are used to assess efficacy of treatment. Reliable outcome measures must have validity, reliability, and responsiveness. One of the challenges in defining surgical treatment strategies for cervical spine disease is the use of subjective outcome measures based largely on the surgeon’s judgment or impression of patient outcome. There are several scoring systems to measure clinical deficits and outcome in cervical spondylopathic myelopathy (CSM). Myelopathy Disability Index, Japanese Orthopaedic Association scale, 36-Item Short Form Health Survey, and gait analysis were found to be valid and reliable measures (Class II) for assessing cervical spondylotic myelopathy (1). There is currently little information comparing outcomes as assessed by different CSM scoring systems. Studies suggest no significant difference in the recovery-rate amongst the majority of the scoring systems, which allows a good comparison of the results from different studies (2). However, it is reported that using the recovery rate to assess outcome is best for comparing studies that use different scores (3).

Below, the list of scoring systems to be used for measure severity of myeleopathy.


1.  Holly LT, Matz PG, Anderson PA, Groff MW, Heary RF, Kaiser MG, Mummaneni PV, Ryken TC, Choudhri TF, Vresilovic EJ, Resnick DK; Joint Section on Disorders of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons and Congress of Neurological Surgeons. Functional outcomes assessment for cervical degenerative disease. J Neurosurg Spine. 2009 Aug;11(2):238-44.

2. Vitzthum HE, Dalitz K. Analysis of five specific scores for cervical spondylogenic myelopathy. Eur Spine J. 2007 December; 16(12): 2096–2103.

3. Dalitz K, Vitzthum HE. Evaluation of five scoring systems for cervical spondylogenic myelopathy. Spine J. 2008 Sep 5.

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