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A summary of assessment tools for patients suffering from cervical spondylotic myelopathy: a systematic review on validity, reliability and responsiveness

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Abstract

Purpose

One of the objectives of this review is to summarize the important features of a good scale. A second aim is to conduct a systematic review to identify scales that can detect the presence of cervical myelopathy and to determine their psychometric properties including validity, reliability and responsiveness.

Methods

A thorough literature search was performed using MEDLINE, MEDLINE in process, EMBASE, and Cochrane Central Register of Controlled Trials. Articles were included in this study if they compared scale measurements between a control and a myelopathic patient population or if they discussed any psychometric property of a scale.

Results

An ideal scale should be one that is quantifiable, valid, sensitive, responsive and easy to perform, has high inter/intra-rater reliability, internal consistency and a suitable distribution, and is one-dimensional and relevant. In the context of cervical spondylotic myelopathy, it is essential that the scale also addresses the pathophysiology, its key signs and symptoms as well as its natural history. For the systematic review, the search yielded 5,745 citations. Of these, 37 met inclusion criteria, 10 explored the ability of a scale to detect myelopathy, 23 examined validity by assessing correlation between scales, 10 reported reliability, 8 analyzed responsiveness, and 6 discussed internal consistency. The most frequently reported scale was short form-36 (n = 16) followed by Nurick grade (n = 14), Japanese Orthopaedic Association (n = 13), (modified) Japanese Orthopaedic Association (n = 7) and grip and release test (n = 6). Four studies each presented results on the Cooper, Harsh and 30-m walking test.

Conclusion

This review summarizes outcome measures used to assess the presence and severity of cervical myelopathy. It includes several validation studies as well as those that have reported the responsiveness and reliability of various measures.

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Abbreviations

BQ:

Bournmouth questionnaire

CMS:

Cooper myelopathy scale

CSM:

Cervical spondylotic myelopathy

CSOQ:

Cervical spine outcomes questionnaire

EMS:

European myelopathy score

GRT:

Grip and release test

ICC:

Intraclass correlation

JOACMEQ:

Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire

KQ:

Key question

MCS:

Mental component score

MDI:

Myelopathy disability index

(m)JOA:

(modified) Japanese Orthopaedic Association

NDI:

Neck disability index

NFDS:

Neck functional disability scale

NPRS:

Numeric pain rating scale

OPLL:

Ossification of the posterior longitudinal ligament

PCS:

Physical component score

PSFS:

Patient-specific functional scale

ROC:

Receiver operating curve

SF-12:

Short form-12

SF-36:

Short form-36

WHOQOL-Bref:

World Health Organization Quality of Life-Bref

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Author information

Authors and Affiliations

  1. Neural Repair and Regeneration, Neurosurgery, University of Toronto, Krembil Neuroscience Spinal Program, 399 Bathurst St., Toronto Western Hospital, Toronto, ON, Canada

    Michael G. Fehlings

  2. Department of Neurosurgery, Toronto Western Hospital, University of Toronto, 399 Bathurst St. W, 4F412, Toronto, ON, M5T 2S8, Canada

    Anoushka Singh & Lindsay Tetreault

  3. Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK

    Adrian Casey

  4. Department of Neurosurgery, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0QQ, UK

    Rodney Laing

  5. Department of Neurosurgery, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, Scotland, UK

    Patrick Statham

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  1. Anoushka Singh
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  2. Lindsay Tetreault
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  3. Adrian Casey
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  4. Rodney Laing
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  6. Michael G. Fehlings
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Corresponding author

Correspondence to Michael G. Fehlings.

Additional information

M. G. Fehlings is Halbert Chair in Neural Repair and Regeneration, Professor of Neurosurgery at University of Toronto, ON, Canada.

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Singh, A., Tetreault, L., Casey, A. et al. A summary of assessment tools for patients suffering from cervical spondylotic myelopathy: a systematic review on validity, reliability and responsiveness. Eur Spine J 24 (Suppl 2), 209–228 (2015). https://doi.org/10.1007/s00586-013-2935-x

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