Outcome Measures for Cervical Spondylotic Myelopathy and Degenerative Cervical Myelopathy: Past, Present, and Future

Surya Dillibabu; Charles H Crawford 3rd; Leah Y Carreon; Steven D Glassman

doi:10.1097/BSD.0000000000002005

Outcome Measures for Cervical Spondylotic Myelopathy and Degenerative Cervical Myelopathy: Past, Present, and Future

Clin Spine Surg. 2026 Jan 13. doi: 10.1097/BSD.0000000000002005. Online ahead of print.

Authors

Surya Dillibabu¹, Charles H Crawford 3rd^{2

3}, Leah Y Carreon³, Steven D Glassman^{2

3}

Affiliations

¹ University of Louisville School of Medicine.
² Department of Orthopaedic Surgery, University of Louisville School of Medicine.
³ Norton Leatherman Spine Center, Louisville, KY.

PMID: 41553741
DOI: 10.1097/BSD.0000000000002005

Abstract

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.

Keywords: CSM; DCM; advanced imaging; cervical spine pathology; clinical outcome measures; patient reported outcome measures (PROMs); wearable sensor data.