This 3-year prospective RCT enrolled 68 patients with mild-to-moderate spondylotic cervical myelopathy (mJOA ≥12) and randomized them to conservative management (soft collar, anti-inflammatories, activity restriction) versus surgery (anterior decompression, corpectomy, or laminoplasty), comparing outcomes on mJOA, timed 10-m walk, blinded video-assessed daily activities, and patient self-evaluation at 6, 12, 24, and 36 months.
When you see a patient with mild-to-moderate CSM (mJOA ≥12) who is neurologically stable or slowly progressive, this trial supports a structured conservative approach — soft collar, anti-inflammatories, activity modification.
As a legitimate first-line strategy, with surgery reserved for documented neurologic deterioration rather than applied prophylactically.
The persistent advantage of conservative treatment on the timed walk test is a reminder that functional gait measures can reveal real differences that provider-scored tools like mJOA may miss.
This 3-year prospective RCT enrolled 68 patients with mild-to-moderate spondylotic cervical myelopathy (mJOA ≥12) and randomized them to conservative management (soft collar, anti-inflammatories, activity restriction) versus surgery (anterior decompression, corpectomy, or laminoplasty), comparing outcomes on mJOA, timed 10-m walk, blinded video-assessed daily activities, and patient self-evaluation at 6, 12, 24, and 36 months.
When you see a patient with mild-to-moderate CSM (mJOA ≥12) who is neurologically stable or slowly progressive, this trial supports a structured conservative approach — soft collar, anti-inflammatories, activity modification.
As a legitimate first-line strategy, with surgery reserved for documented neurologic deterioration rather than applied prophylactically.
The persistent advantage of conservative treatment on the timed walk test is a reminder that functional gait measures can reveal real differences that provider-scored tools like mJOA may miss.