Upper Extremity Sensation After Surgery for Degenerative Cervical Myelopathy, Does It Change? An Observational Study From the Canadian Spine Outcomes and Research Network (CSORN).

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.