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Modified JOA can serve as cervical myelopathy functionality standard
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A gold standard to measure functionality in patients with cervical spondylotic myelopathy has not yet been established, but recently published study results suggest the modified Japanese Orthopaedic Association scale should be adopted, according to researchers.
The researchers assessed the evaluation properties of the modified Japanese Orthopaedic Association (mJOA) scale using data from 277 surgical patients with cervical spondylotic myelopathy (CSM). All patients received anterior or posterior decompression and reconstruction at one of 12 North American centers included in the study. Patients’ functional status was analyzed at baseline and again at 6, 12 and 24 months.
The researchers assessed the internal consistency of the 18-item scale by computing a Cronbach alpha for the total score, as well as after removing each scale component one at a time. The scale’s validity and divergent validity was correlated with other assessment tools, such as the Nurick score, Neck Disability Index, SF-36v2 and 30-m walk test. Additionally, through the comparison of mJOA scores from baseline and 12 months postoperatively, as well as the computation of Cohen effect size, the researchers attempted to determine the scale’s responsiveness.
The Cronbach alpha was 0.63, which showed the scale’s internal consistency to be moderate, according to the researchers.
The researchers found the mJOA scale to be responsive, as demonstrated by the difference in mean mJOA at baseline and 12 months. The scale also demonstrated its convergent and divergent validity based on associations with other scales, according to data in the study.
The researchers concluded the mJOA scale is a useful tool in assessing CSM and should be the standard scale used by physicians.
Disclosure: Funds were received from AO Spine for the collection of original data used in this work.
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