The modified Japanese Orthopaedic Association scale: establishing criteria for mild, moderate and severe impairment in patients with degenerative cervical myelopathy
The modified Japanese Orthopaedic Association scale: establishing criteria for mild, moderate and severe impairment in patients with degenerative cervical myelopathy
复制标题
DOI：
10.1007/s00586-016-4660-8
复制
发表时间：
2017-01-01
影响因子：
2.8
通讯作者：
Fehlings, Michael G.
中科院分区：
文献类型：
--
作者：
Tetreault, Lindsay;Kopjar, Branko;Fehlings, Michael G.
在2005年12月至2011年1月期间，757名临床诊断为DCM的患者参加了26个地点的AOSpine North America(n=278)或International(n=479)前瞻性研究，目的是根据改良的日本骨科学会(MJOA)评分确定轻、中、重度脊髓病的界限。在基线时使用各种结果测量来评估功能状态和生活质量。以Nurick评分为指标，进行受试者工作曲线(ROC)分析，以确定轻、中、重度疾病的界限。通过检查不同严重程度组的患者在损害、残疾、生活质量以及体征和症状数量方面的差异来评估确定的分界点的有效性。mJOA14被确定为轻度和中度脊髓病之间的分界点，MJOA11是中度和重度疾病之间的分界点。与轻度组(n=190)和中度组(n=296)相比，重度脊髓病组(n=254)患者的生活质量和功能状态显著降低，体征和症状明显增多。轻度脊髓病定义为15~17岁，中度患者定义为12~14岁，重度患者定义为0~11岁。这些分类应在全球范围内采用以规范DCM的临床评估。
We aimed to determine cut-offs between mild, moderate and severe myelopathy on the modified Japanese Orthopedic Association (mJOA) score.Between December 2005 and January 2011, 757 patients with clinically diagnosed DCM were enrolled in the prospective AOSpine North America (n = 278) or International (n = 479) study at 26 sites. Functional status and quality of life were evaluated at baseline using a variety of outcome measures. Using the Nurick score as an anchor, receiver operating curve (ROC) analysis was conducted to determine cut-offs between mild, moderate and severe disease. The validity of the identified cut-offs was evaluated by examining whether patients in different severity groups differed in terms of impairment, disability, quality of life and number of signs and symptoms.A mJOA of 14 was determined to be the cut-off between mild and moderate myelopathy and a mJOA of 11 was the cut-off score between moderate and severe disease. Patients in the severe myelopathy group (n = 254) had significantly reduced quality of life and functional status and a greater number of signs and symptoms compared to patients classified as mild (n = 190) or moderate (n = 296).Mild myelopathy can be defined as mJOA from 15 to 17, moderate as mJOA from 12 to 14 and severe as mJOA from 0 to 11. These categories should be adopted worldwide to standardize clinical assessment of DCM.