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AIIMS Cervical Myelopathy Score – A New Comprehensive and Objective Patient-Reported Modification of mJOA: Results of an Internal Validation Study

Background: Several scoring systems have been developed for assessment of patients with compressive cervical myelopathy. However, all of these have some shortcomings. We proposed a new modification of the modified… Click to show full abstract

Background: Several scoring systems have been developed for assessment of patients with compressive cervical myelopathy. However, all of these have some shortcomings. We proposed a new modification of the modified Japanese Orthopedic Association (mJOA) score—the AIIMS cervical myelopathy score (ACMS). Objective: The aim of this study was to compare the ACMS with mJOA score and Nurick score. Methods: We prospectively studied patients with cervical compressive myelopathy. The new ACMS, mJOA, Nurick proposed by Benzel, and Nurick scores were recorded preoperatively and at three months postoperatively in patients. Results: Sixty-two patients completed the 3-month follow-up and were included in the final analysis. The mean preoperative and postoperative Nurick, mJOA, and ACMS scores were 3.3 and 3.0, 12.3 and 13.8, and 15.1 and 17.7, respectively. High correlation (Pearson's r > 0.8, 95% CI: 0.94 to 0.97, P < 0.005) was observed between ACMS and mJOA scores for all the individual components of both scales, both in pre- and postoperative assessments. A negative correlation was observed between the occupational ability scores ACMS and the Nurick scale (r = −0.76, 95% CI: −0.83 to − 0.68). No correlation was found with cord/canal ratio on magnetic resonance imaging (MRI) with any of the three scoring systems (preoperative, postoperative, or recovery rates). Conclusions: The ACMS score showed a good correlation with the mJOA score for evaluation of functional disability in the setting of cervical myelopathy. The patients could themselves report the scores using the ACMS scoring chart. The occupational component of the ACMS also correlated well with the Nurick score.

Keywords: aiims cervical; modification; myelopathy score; mjoa; cervical myelopathy

Journal Title: Neurology India
Year Published: 2022

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