Comparison of Nurick Score and Modified Japanese Orthopaedic Association Score as Prognostic Indices for Surgical Outcome in Cervical Spondylotic Myelopathy Cases: A Prospective Observational Study

Introduction: Cervical Spondylotic Myelopathy (CSM) is a leading cause of spinal cord dysfunction, particularly in elderly populations. It presents with diverse motor, sensory and autonomic symptoms. Surgical decompression is the standard treatment, with prognostic tools such as the Nurick score and modified Japanese Orthopaedic Association (mJOA) score used to assess outcomes. Aim: To compare the Nurick and mJOA scores in predicting functional outcomes following surgical intervention for CSM. Materials and Methods: A prospective observational study was conducted over three years in the Neurosurgery Department of Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India, from December 2021 to December 2024, including 40 patients diagnosed with CSM. Pre- and postoperative evaluations were performed using the Nurick score, mJOA score and Odom’s criteria. Surgical interventions included anterior or posterior decompression. Statistical analyses included Wilcoxon signed-rank tests and Spearman’s correlation to assess changes in scores and relationships with Odom’s criteria. Results: The mean age of participants was 52.88±15.17 years. The median pre- and postoperative Nurick scores were 3 and 1, respectively (p-value<0.0001), while mJOA scores improved from 14 to 16 (p-value<0.0001). Both scores demonstrated a strong correlation with Odom’s criteria after surgery, with the mJOA score showing a greater association (ρ=-0.599 vs. ρ=0.502). Out of 40 cases, 35 patients (87.5%) showed improvement in their mJOA scores, while 29 patients (72.5%) demonstrated improvement in their Nurick scores at follow-up. Conclusion: The mJOA score provides a more comprehensive evaluation of functional recovery in CSM patients, while the Nurick score remains valuable for rapid assessments. A tailored use of these tools based on clinical context and healthcare settings is recommended.