Faculty Collaboration Database

Assessing the diagnostic accuracy of symptoms and signs of degenerative cervical myelopathy: A prospective study. Sci Rep 2025 Oct 23;15(1):37043

Date

10/24/2025

Pubmed ID

41131090

Pubmed Central ID

PMC12550042

DOI

10.1038/s41598-025-20928-4

Scopus ID

2-s2.0-105019822440 (requires institutional sign-in at Scopus site)

Abstract

Degenerative cervical myelopathy (DCM) is a clinical diagnosis based on history, physical exam, and imaging, but standardized criteria have not been established, contributing to diagnostic delays. We conducted a prospective study of DCM and healthy subjects that comprehensively evaluated symptoms, patient-reported and clinician-administered outcome measures, and physical assessments of motor and sensory function.Diagnostic utility was evaluated using Youden's Index (YI=sensitivity+specificity-1). 139 DCM patients and 108 age-matched healthy subjects were compared. Distinguishing symptoms included neck pain (YI=63%), upper extremity (UE) numbness (YI=57%), hand clumsiness (YI=50%), walking imbalance (YI=50%), and UE weakness (YI=46%). Questionnaires performed well including mJOA (YI=72%), NDI (YI=63%), and EQ-5D (YI=57%). Physical testing showed best results with UE reflexes (YI=54%), strength in 5 UE muscle groups (YI=53%), Berg Balance scale (YI=50%), self-paced walking velocity (YI=48%), and tandem gait assessment (YI=40%). Hand dexterity, strength dynamometry, and testing of 5 sensory modalities demonstrated poor diagnostic utility. Diagnosis of DCM is challenging, but key symptoms include neck pain, UE weakness, and those captured by the mJOA (particularly UE numbness, hand clumsiness, and walking imbalance). Physical testing of reflexes, manual motor testing, and gait/balance are useful to confirm the diagnosis. These findings offer guidance for clinicians and the development of diagnostic criteria.

Author List

Soufi K, Ortuno O, Castillo JA, de Souza NFS, Perez T, Ghabussi G, Chu T, Kim KD, Price R, Javidan Y, Le HV, Roberto RF, Khan S, Klineberg EO, Tetreault L, Davies B, Zipser CM, Nouri A, Kurpad S, Aarabi B, Kwon BK, Kalsi-Ryan S, Fehlings MG, Martin AR

Author

Shekar N. Kurpad PhD, MD President in the President department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Case-Control Studies
Cervical Vertebrae
Female
Humans
Male
Middle Aged
Neck Pain
Prospective Studies
Spinal Cord Diseases
Surveys and Questionnaires