Correlation of Myelopathy to Regional Neck Disability: A Surgical Approach-Specific Analysis in 217 Patients
Bibliographic record
Abstract
Introduction Outcomes for cervical spondylotic myelopathy (CSM) have been measured by numerous health-related quality of life (HRQOL) scales such as the disease-specific modified Japanese Orthopaedic Association (mJOA) and the regional-specific neck disability index (NDI). However, there is no literature analyzing the correlation of myelopathy improvement to regional neck disability changes after surgery. Materials and Methods Post hoc analysis of a prospective, multicenter database of patients with CSM. A total of 217 patients (78%) met the following inclusion criteria: symptomatic CSM, age over 18 years, and 6 months follow-up with mJOA and NDI. The patient population had a mean age of 57 years and 42% were females ( n = 92). NDI and mJOA were analyzed at baseline and 6 months post-op for the entire group. Correlations were also analyzed by the following subgroups: anterior approach group (AAG, n = 141) and posterior approach group (PAG, n = 76). Results From baseline to 6 months, there was a statistically significant improvement in both mJOA (BL 12.87–6 M 15.25, p < 0.0001) and NDI (BL 42.25–6M 31.61, p < 0.0001) in the overall group. There was a significant small negative correlation between NDI and mJOA at baseline ( R = − 0.34, p < 0.0001) and at 6-month follow-up ( R = − 0.44, p < 0.0001). Within the AAG, there was also a significant negative correlation between NDI and mJOA at baseline ( R = − 0.31, p < 0.0001) and 6 months ( R = − 0.53, p < 0.0001). Within the PAG, there was also a significant negative correlation between NDI and mJOA at baseline ( R = − 0.43, p < 0.0001) and 6 months ( R = − 0.34, p = 0.003). Conclusion Overall, NDI has a significant negative correlation with mJOA at baseline and postoperatively in patients with CSM. This correlation increases postoperatively in the overall group. The PAG showed a decrease in the correlation coefficient after surgery, whereas the AAG showed an increase. This could be because the posterior approach tended to be a more extensive surgery for multilevel disease in older patients, compared with the anterior approach, resulting in more soft tissue disruption and a delay in neck active motion. Regardless of the approach, mJOA still remains significantly correlated with NDI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".