The Spine Journal
Spine Free Articles
Despite the numerous studies examining the relationship of cord signal changes CSC with outcomes of both surgical and nonsurgical treatment of cervical spondylotic myelopathy CSM, there have not been any studies examining specifically the relationship of physical examination findings with CSC.
CSC visualized on MRI correlates poorly with the upper extremity reflex examination in patients with cervical myelopathy. Of the pathological reflexes, Hoffman sign has the strongest association with CSC, but still was only positive in 67% of cases. More sensitive clinical measures need to be developed to more accurately associate CSC detected on MRI to the clinical severity of cervical spondylotic myelopathy. 1)
1) Nemani VM, Kim HJ, Piyaskulkaew C, Nguyen JT, Riew KD. Correlation of cord signal change with physical examination findings in patients with cervical myelopathy. Spine (Phila Pa 1976). 2015 Jan 1;40(1):6-10. doi: 10.1097/BRS.0000000000000659. PubMed PMID: 25341986.
The modified Japanese Orthopaedic Association scale (mJOA) demonstrates both convergent and divergent validity and is responsive to change. These results validate existing studies and justify the use of this tool in further research efforts. Kopjar et al. hope this study will promote the global standardization of assessment tools and encourage clinicians to use the mJOA, alongside other ancillary measures, to evaluate functional status in patients with cervical spondylotic myelopathy (CSM). 1).
1) Kopjar B, Tetreault L, Kalsi-Ryan S, Fehlings M. Psychometric properties of the modified Japanese orthopaedic association scale in patients with cervical spondylotic myelopathy. Spine (Phila Pa 1976). 2015 Jan 1;40(1):E23-8. doi:10.1097/BRS.0000000000000648. PubMed PMID: 25341993.