mJOA Score

What is the Modified Japanese Orthopedic Association Score (mJOA)?

The Modified Japanese Orthopedic Association Score (mJOA) is a clinical tool used primarily to assess the severity and prognosis of spinal cord injuries, particularly in cases of cervical myelopathy. This scoring system is an adaptation of the original JOA score, designed to provide a more detailed evaluation of neurological function, and has been widely used to determine both the initial impact of spinal cord damage and the outcomes after various treatments.

The mJOA score evaluates several aspects of neurological function, including motor skills in the front upper extremity and lower extremities, sensory function, and bladder control. Each category is scored based on the severity of impairment, with the total score indicating the overall level of function. A higher score represents better neurological function and less severe impairment.

The mJOA score provides a quantitative assessment of motor and sensory functions essential for treatment planning. The score ranges typically from 0 to 18, with various functions scored as follows:

• Motor function of upper extremities: This is graded from 0 (paralysis) to 4 (normal strength).
• Motor function of lower extremities: Also graded from 0 (paralysis) to 4 (normal strength).
• Sensory function: Includes the evaluation of touch and proprioceptive sensations, scored from 0 (loss of sensation) to 3 (normal sensation).
• Sphincter function: Assessed from 0 (poor control) to 3 (normal control).

The scoring allows physicians to quantitatively assess the impairment level of patients suffering and track changes over time. The mJOA score is particularly useful for assessing degenerative cervical myelopathy, and patients with cervical spondylotic myelopathy can also greatly benefit from assessments using this score.

Next steps after using this score

After using the mJOA to assess the extent of spinal cord impairment, strategic steps must be taken to manage and improve the patient's condition.

Step 1: Assess baseline function

Utilize the mJOA score to establish a baseline level of neurological function immediately following injury or onset of symptoms.

Step 2: Plan treatment

Based on the outcome measures of the mJOA score, healthcare providers can formulate a treatment strategy that may include physical therapy or other rehabilitative services. Surgical decompression may be considered based on the mJOA scores if conservative measures are insufficient.

Step 3: Monitor progress

Regular reassessment with the mJOA score helps monitor the treatment's effectiveness and adjust the intervention as needed to optimize recovery.

Step 4: Long-term follow-up

Continuous evaluation using the mJOA score during follow-up visits aids in assessing long-term outcomes and assessing functional status during recovery. Patient-reported outcome measures are also integral to evaluating the subjective success of interventions.

How to use our mJOA Score template

Our mJOA Score template is designed to streamline the assessment of spinal cord function. The template helps in defining disease severity through detailed assessments, which is crucial for effective management. By following these steps, you can effectively utilize the template to enhance your diagnostic accuracy and patient care planning.

Step 1: Fill in basic information

Start by entering the patient's name, date of birth, surgery date, and today’s date at the top of the template. This ensures all assessments are properly documented and easily traceable.

Step 2: Assess motor dysfunction of the upper extremities

Ask the patient to move their hands, eat with a spoon, and button a shirt. Circle the corresponding score on the template based on their ability to perform these tasks, ranging from 0 (inability to move hands) to 5 (no dysfunction).

Step 3: Evaluate motor dysfunction of the lower extremities

Examine the patient's leg movements and walking capabilities. Score their function based on criteria ranging from complete loss of motor and sensory function to no dysfunction. Ensure to note if any aids like canes or handrails are used.

Step 4: Test sensation

Check for any loss of hand sensation and assess the degree of sensory loss or pain. Circle the score that best describes the patient’s condition, from complete loss of sensation to no sensory loss.

Step 5: Determine sphincter dysfunction

Evaluate the patient’s ability to urinate voluntarily and the level of difficulty they experience. Score their bladder function from inability to urinate voluntarily to normal micturition.

Step 6: Calculate the total score and classify myelopathy

Sum the scores from all sections to find the total mJOA score. Use the total to classify the following: mild myelopathy (15-17), moderate myelopathy (12-14), or severe myelopathy (0-11).

Benefits of using the mJOA Score

The mJOA is a pivotal tool in the field of neurology and orthopedics, particularly in the assessment and management of spinal cord injuries. Its benefits are multifaceted, impacting both clinical outcomes and patient care. Here are the key advantages of using the mJOA score:

1. Precision in assessment: The mJOA score offers a detailed and systematic approach to evaluating the extent of neurological deficits, allowing clinicians to pinpoint specific areas of impairment. This precision facilitates targeted interventions that are more likely to yield positive outcomes.
2. Guidance for treatment: By quantifying the severity of a patient's condition, the mJOA score aids in formulating a tailored treatment plan. It helps decide whether conservative management, surgical intervention, or a combination of both is appropriate based on the patient’s specific needs.
3. Monitoring rehabilitation: The mJOA score is invaluable in tracking the progress of rehabilitation efforts. Alongside the mJOA score, ancillary outcome measures are used to capture broader aspects of patient health and response to treatment.
4. Enhancing communication: A standardized scoring system improves communication among healthcare providers. It ensures that all team members clearly understand the patient's condition, which enhances coordination of care.
5. Benchmarking and research: The mJOA score is widely recognized and used globally, making it a useful benchmark in clinical studies. Statistical analysis of mJOA scores also enhances our understanding of treatment outcomes for spinal cord injuries.