COSMIN database

Functional outcomes assessment for cervical degenerative disease

Holly, L. T., Matz, P. G., Anderson, P. A., Groff, M. W., Heary, R. F., Kaiser, M. G., Mummaneni, P. V., Ryken, T. C., Choudhri, T. F., Vresilovic, E. J., Resnick, D. K., Joint Section on Disorders of the, Spine, Peripheral Nerves of the American Association of Neurological, Surgeons, and Congress of Neurological, Surgeons
OBJECT: The objective of this systematic review was to use evidence-based medicine to identify valid, reliable, and responsive measures of functional outcome after treatment for cervical degenerative disease.

METHODS: The National Library of Medicine and Cochrane Database were queried using MeSH headings and key words relevant to functional outcomes. Abstracts were reviewed after which studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons.

RESULTS: Myelopathy Disability Index, Japanese Orthopaedic Association scale, 36-Item Short Form Health Survey, and gait analysis were found to be valid and reliable measures (Class II) for assessing cervical spondylotic myelopathy. The Patient-Specific Functional Scale, the North American Spine Society scale, and the Neck Disability Index were found to be reliable, valid, and responsive (Class II) for assessing radiculopathy for nonoperative therapy. The Cervical Spine Outcomes Questionnaire was a reliable and valid method (Class II) to assess operative therapy for cervical radiculopathy.

CONCLUSIONS: Several functional outcome measures are available to assess cervical spondylotic myelopathy and cervical radiculopathy.
J Neurosurg Spine
1547-5654 (Print)
Publication year:
Functional status:
Cognitive/mental functioning
Physical functioning
Social functioning
Adults (18-65)
Children (0-18)
Seniors (65+)
Diseases of and symptoms related to the musculoskeletal system and connective tissue
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
4 - Performance-based tests
6 - Clinical rating scales
30 meter walk test
CSOQ - Cervical Spine Outcome Questionnaire
EMS - European Myelopathy Score
Gait analysis
JOA - Myelopathy scale of the Japanese Orthopaedic Association
MDI - Myelopathy Disability Index
NASS - North American Spine Society Questionnaire (versions: lumbar spine outcome; NASS-cervical - NASS-cervical outcome; NASS-AAOS - North American Spine Society-American Academy of Orthopedic Surgeons)
NDI - Neck Disability Index    
Nurick score
Odom's criteria
PSFS - Patient-Specific Functional Scale   
Ranawat score
SF-12 - 12-item Short Form Health Survey [alias: RAND-12]
SF-36 - 36-item Short Form Health Survey [alias: RAND-36][alias: Medical Outcomes Study (MOS) SF-36]]    |  | also see: