This protocol covers the management of degenerative cervical myelopathy (DCM) in patients who present with signs and symptoms of myelopathy, imaging evidence of cervical spinal cord compression, and a modified Japanese Orthopedic Association (mJOA) score at or below 11—placing them in the severe category.
Degenerative cervical myelopathy with an mJOA score ≤ 11 (severe grade) and MRI-confirmed cervical spinal cord compression. By the mJOA grading system, a score of 15 indicates mild myelopathy, 12–14 moderate, and 11 or below severe. Diagnosis requires both clinical signs and symptoms consistent with myelopathy and imaging evidence of cord compression.
In patients with severe DCM (mJOA ≤ 11), a surgical approach directed at the cervical spinal cord is recommended. The complete intervention details, decision criteria, and procedural sequence are contained in the full protocol.
DOI: 10.1177/2192568217703088
Based on the mJOA score, mild myelopathy is defined as 15, moderate as 12 to 14, and severe as 11.
DCM is diagnosed when a patient presents with signs and symptoms consistent with myelopathy and image (usually magnetic resonance imaging [MRI]) evidence of spinal cord compression.
We recommend surgical intervention for patients with severe DCM.
Success has been defined based on final postoperative score (eg, mJOA ≥ 16), recovery rate or achieving a MCID.
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