Spine - 2026-06-15 - Journal Article; Observational Study; Multicenter Study
Upper Extremity Sensation After Surgery for Degenerative Cervical Myelopathy, Does It Change? An Observational Study From the Canadian Spine Outcomes and Research Network (CSORN).
Karthikeyan V, Dea N, Malhotra AK, Shakil H, Cadotte DW, Singh S, Weber MH, Phan P, Glennie A, Wang Z, Small C, Soroceanu A, Urquhart JC, Paquet J, Christie SD, Rampersaud R, Evaniew N, Wilson JR
Topics
Key Takeaway
Among DCM patients with baseline sensory deficits, 50% demonstrated mJOA sensory subdomain improvement at 12 months, independently associated with +1.98-point PCS and +2.34-point MCS gains on SF-12.
Summary Depth
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Summary
This CSORN multicenter study quantified mJOA upper extremity sensory subdomain recovery in DCM patients at 3 and 12 months post-decompression and correlated outcomes with SF-12 HRQoL. Of 490 patients with complete 12-month data, 50% improved, 46% remained stable, and 4% worsened; sensory improvement independently predicted higher PCS (+1.98) and MCS (+2.34) in adjusted models. Worse baseline upper and lower extremity motor scores were independent predictors of sensory recovery (ORs 0.78 and 0.75, respectively), suggesting floor-effect-driven recovery potential in more severely affected patients.
Key Limitation
The mJOA sensory subdomain is a 2-point ordinal scale with limited granularity, potentially underdetecting partial sensory recovery and compressing the true distribution of outcomes.
Original Abstract
STUDY DESIGN
Multicenter observational cohort study.
OBJECTIVE
To quantify upper extremity sensory recovery following surgical decompression for degenerative cervical myelopathy (DCM), identify predictors of sensory improvement, and evaluate its association with postoperative health-related quality of life (HRQoL).
SUMMARY OF BACKGROUND DATA
Sensory dysfunction is a hallmark feature of DCM. However, prior studies have focused on overall neurological improvement rather than domain-specific outcomes, leaving the trajectory and impact of sensory recovery poorly characterized.
METHODS
We used prospectively collected data from the Canadian Spine Outcomes and Research Network (CSORN). Sensory function was assessed using the modified Japanese Orthopedic Association (mJOA) sensory subdomain at baseline, 3 months, and 12 months postoperatively. Changes in sensory score were categorized as improved, stable, or worsened. HRQoL was evaluated using the SF-12 Physical and Mental Component Scores (PCS and MCS). Multivariable linear regression was performed to assess the independent association between sensory improvement and 12-month PCS and MCS. Multivariable logistic regression identified predictors of sensory improvement.
RESULTS
Among 682 patients with baseline sensory deficits, 490 had 12-month follow-up data. Of these, 245 (50%) demonstrated sensory improvement, 226 (46%) remained stable, and 19 (4%) worsened ( P <0.001). Patients who improved experienced significant increases in PCS (from 31.4 to 40.5, P <0.001) and MCS (from 42.7 to 48.0, P <0.001). In adjusted models, sensory improvement was independently associated with higher PCS (+1.98, P =0.016) and MCS (+2.34, P =0.007), while worse baseline upper and lower extremity motor scores predicted greater odds of recovery (ORs 0.78 and 0.75, respectively).
CONCLUSIONS
Sensory improvement after surgical decompression for DCM is common and independently associated with meaningful HRQoL gains. Patients with more severe baseline motor deficits are more likely to improve. These findings highlight the prognostic value of baseline function and support incorporating sensory outcomes into preoperative counseling.