Poster Presentation Sydney Spinal Symposium 2026

Update from the MYNAH Registry: A comparison of long-term trajectories for operated and unoperated individuals with degenerative cervical myelopathy (#124)

Ryan M Dorrian 1 , Nashwa Najib 1 , Asees Kaur 1 , Ben Maslen 2 , Takeru Akabane 1 , Ryan Quarrington 1 , Ryan O'Hare Doig 1 , Ralph Mobbs 3 , Aaron Stevenson 4 , Ashish Diwan 1
  1. SpineLabs, Adelaide University, Adelaide, South Australia, Australia
  2. School of Mathematics & Statistics, University of New South Wales, Sydney, New South Wales, Australia
  3. NeuroSpine Surgery Research Group (NSURG), Prince of Wales Private Hospital, Randwick, New South Wales, Australia
  4. Spinal Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia

Introduction

Degenerative cervical myelopathy (DCM) is a chronic, progressive condition causing neurological deficits due to cervical spinal cord compression. Current guidelines strongly recommend surgical management for moderate-to severe DCM; however, mild DCM is often managed both operatively and non-operatively. The lack of long-term comparative evidence between management strategies poses a significant challenge to clinical decision-making.

Aim

To compare mJOA score trajectories between operative and non-operative DCM cases from the MYNAH registry.

Method

Data were extracted from the MYNAH registry (1st June 2026) and filtered to include participants with a known operative status and DCM diagnosis date. Time since DCM diagnosis was calculated from diagnosis to MYNAH registry enrolment date. Enrolment mJOA scores were plotted against time since diagnosis with a linear regression fitted separately per group. Results are reported as median [range] for time since diagnosis. Fitted mJOA scores are reported at the first and last available time points. Inferential statistics were not performed given the preliminary nature of this study.

Results

26 participants were included (Operated: n=10, Unoperated: n=16). Operated participants had a longer time since diagnosis at enrolment than unoperated (6.9 [0.02-35.6] vs 1.9 [0.05-10.3] years). At the earliest available timepoint, fitted mJOA scores were higher in the operated group (17.1) than unoperated (15.5). Unoperated mJOA scores remained stable over time (slope: +0.08 points/year), while operated scores showed a gradual decline (slope: -0.056 points/year). At the latest unoperated time available (10.3 years), fitted mJOA scores were comparable between groups (operated: 16.5, unoperated: 16.3). The operated group continued to decline to 15.1 at the final timepoint (35.6 years).

Conclusion

Preliminary data suggests improved early outcomes in operative DCM cases, though mJOA scores gradually declined over time, while unoperated remained stable. Expanded datasets with longer unoperated follow-up are required for conclusive comparisons between management strategies.