Upper Extremity Sensation After Surgery for Degenerative Cervical Myelopathy, Does it Change? An Observational Study from the Canadian Spine Outcomes and Research Network (CSORN)

Vishwathsen Karthikeyan; Nicolas Dea; Armaan K Malhotra; Husain Shakil; David W Cadotte; Supriya Singh; Michael H Weber; Philippe Phan; Andrew Glennie; Zhi Wang; Chris Small; Alex Soroceanu; Jennifer C Urquhart; Jérôme Paquet; Sean D Christie; Raja Rampersaud; Nathan Evaniew; Jefferson R Wilson

doi:10.1097/BRS.0000000000005507

Upper Extremity Sensation After Surgery for Degenerative Cervical Myelopathy, Does it Change? An Observational Study from the Canadian Spine Outcomes and Research Network (CSORN)

Spine (Phila Pa 1976). 2025 Sep 16. doi: 10.1097/BRS.0000000000005507. Online ahead of print.

Authors

Vishwathsen Karthikeyan^{1

2

3}, Nicolas Dea⁴, Armaan K Malhotra^{1

2

3}, Husain Shakil^{1

2

3}, David W Cadotte⁵, Supriya Singh⁶, Michael H Weber⁷, Philippe Phan⁸, Andrew Glennie⁹, Zhi Wang¹⁰, Chris Small⁹, Alex Soroceanu⁵, Jennifer C Urquhart⁶, Jérôme Paquet¹¹, Sean D Christie¹², Raja Rampersaud¹³, Nathan Evaniew⁵, Jefferson R Wilson^{1

2

3}

Affiliations

¹ Division of Neurosurgery, Department of Surgery, University of Toronto, 149 College Street, 5th Floor, Toronto, Ontario, M5T 1P5, Canada.
² Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria St, Toronto, Ontario, M5B 1T8, Canada.
³ Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
⁴ Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopedics Surgery, University of British Columbia, 11th Floor, 2775 Laurel Street, Vancouver, British Columbia, V5Z 1M9, Canada.
⁵ University of Calgary Spine Program, University of Calgary, Foothills Medical Center, 1409 29 Street NW, Calgary, Alberta, T2N 2T9, Canada.
⁶ London Health Science Centre Combined Orthopaedic and Neurosurgery Spine Program, Schulich School of Medicine, Western University, 1151 Richmond Street, London, Ontario N6A 5C1, Canada.
⁷ Division of Orthopaedics, McGill University Health Centre, 3650 Rue Saint-Urbain Bureau K 124, Montreal, Quebec H2X 2P4, Canada.
⁸ Division of Orthopaedic Surgery, University of Ottawa, Ottawa Hospital, 1053 Carling Avenue, Ottawa, Ontario, K1Y 4E9, Canada.
⁹ Department of Surgery, Division of Orthopedics, Dalhousie University, 6230 Coburg Rd, Halifax, Nova Scotia B3H 4J5, Canada.
¹⁰ Orthopedics, Centre Hospitalier Universitaire de Montréal, Montreal, Quebec, Canada.
¹¹ Hôpital de L'Enfant-Jésus, Laval University, 401 18E Rue, Quebec City, Quebec G1J 1Z4, Canada.
¹² Department of Surgery, Division of Neurosurgery, Dalhousie University, Halifax Infirmary, 1796 Summer Street, Halifax, NS, B3H 3A7.
¹³ Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Orthopaedics, Department of Surgery, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada.

PMID: 40955710
DOI: 10.1097/BRS.0000000000005507

Abstract

Study design: Multicenter observational cohort study.

Objective: To quantify upper extremity sensory recovery following surgical decompression for degenerative cervical myelopathy (DCM), identify predictors of sensory improvement, and evaluate its association with postoperative health-related quality of life (HRQoL).

Summary of background data: Sensory dysfunction is a hallmark feature of DCM. However, prior studies have focused on overall neurological improvement rather than domain-specific outcomes, leaving the trajectory and impact of sensory recovery poorly characterized.

Methods: We used prospectively collected data from the Canadian Spine Outcomes and Research Network (CSORN). Sensory function was assessed using the modified Japanese Orthopedic Association (mJOA) sensory subdomain at baseline, 3-months, and 12-months postoperatively. Changes in sensory score were categorized as improved, stable, or worsened. HRQoL was evaluated using the SF-12 Physical and Mental Component Scores (PCS and MCS). Multivariable linear regression was performed to assess the independent association between sensory improvement and 12-month PCS and MCS. Multivariable logistic regression identified predictors of sensory improvement.

Results: Among 682 patients with baseline sensory deficits, 490 had 12-month follow-up data. Of these, 245 (50%) demonstrated sensory improvement, 226 (46%) remained stable, and 19 (4%) worsened (P<0.001). Patients who improved experienced significant increases in PCS (from 31.4 to 40.5, P<0.001) and MCS (from 42.7 to 48.0, P<0.001). In adjusted models, sensory improvement was independently associated with higher PCS (+1.98, P=0.016) and MCS (+2.34, P=0.007), while worse baseline upper and lower extremity motor scores predicted greater odds of recovery (ORs 0.78 and 0.75, respectively).

Conclusions: Sensory improvement after surgical decompression for DCM is common and independently associated with meaningful HRQoL gains. Patients with more severe baseline motor deficits are more likely to improve. These findings highlight the prognostic value of baseline function and support incorporating sensory outcomes into preoperative counseling.

Keywords: Degenerative cervical myelopathy; Health-related quality of life; Sensory function; Surgical management; mJOA.