Input the functional status metrics to determine the mJOA score and guide cervical myelopathy management.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Defining the severity of Degenerative Cervical Myelopathy (DCM).
Surgical thresholding: Severe (0-11) and Moderate (12-14) generally mandate decompression surgery. Mild (15-17) can be managed non-operatively with careful observation in some patients.
Section 2
Literature
Modification for the West
The original JOA scale included assessing upper extremity function by evaluating a patient's ability to use chopsticks. The Modified JOA (mJOA), spearheaded by Fehlings et al., replaced chopsticks with spoons/forks/cutlery to make it cross-culturally valid in Western populations, changing the max score from 17 to 18.
Section 3
Pearls/Pitfalls
Tracking Recovery
The mJOA is the numerator in the Hirabayashi recovery rate calculation. A preoperative mJOA of < 12 carries a poorer prognosis for full neurological recovery even after a technically perfect spinal decompression.
Section 4
Evidence Appraisal
Primary Reference
The modified Japanese Orthopaedic Association scale: establishing criteria for mild, moderate and severe impairment in patients with degenerative cervical myelopathy
Tetreault L et al. • Eur Spine J. 2017;26(1):78-84
