Table 1.
Inclusion and Exclusion Criteria.
| Characteristic | Inclusion | Exclusion |
|---|---|---|
| Population | Patients with cervical myelopathy secondary to spondylosis, disc herniation, ossification of the posterior longitudinal ligament, congenital stenosis or subluxation Managed conservatively or surgically Age >18 years |
Patient with traumatic spinal cord injury, thoracic or lumbar myelopathy, spondylosis without myelopathy, tumor or infection Patients with asymptomatic spinal cord compression Patients with DCM at a specific level |
| Clinical signs | Hoffmann Inverted supinator Finger escape Suprapatellar quadriceps Babinski Pectoralis reflex Hyperreflexia (biceps, triceps, quadriceps, ankle) Clonus Gait abnormalities Romberg Other |
Patient reported symptoms Patient reported outcome measures (eg NDI, SF-36, VAS, subjective questionnaires) Clinician reported outcome measures (eg mJOA, nurick, walking test, grip dynamometer, GRASSP, GaitRite) Imaging characteristics |
| Outcome | KQ1: Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio KQ2: Disease severity as measured by standardized outcome instruments (eg mJOA, nurick, 30-m walking test, NDI, SF-36) |
KQ1: Reliability, responsiveness to change, internal consistency KQ2: Non-standardized outcome instruments (eg subjective rating of symptoms) or imaging findings |
| Study design | Case-control, cohort, cross-sectional, observational studies KQ1: Studies that report frequency of clinical signs in a cohort of DCM patients KQ1: Studies that include an acceptable control group for comparison (eg individuals with cervical radiculopathy or axial neck pain with no myelopathic symptoms) KQ2: Studies that statistically evaluate the association between the presence of a clinical sign and disease severity |
Commentaries or opinions Systematic or narrative reviews Animal or biomechanical studies Studies with <15 patients |
NDI, neck disability index; SF-36, short form-36; VAS, visual analog scale; mJOA, modified Japanese Orthopedic Association; GRASSP, graded redefined assessment of strength, sensation and prehension; KQ, key question; DCM, degenerative cervical myelopathy.