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JOA Cervical Spondylotic Myelopathy Score

Subjective Symptoms
Low Back Pain
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Low Back Pain
No low back pain
Occasional mild pain
Frequent low back pain
Severe low back pain
Lower Limb Pain and Numbness
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Lower Limb Pain and Numbness
No lower limb pain or numbness
Occasional mild pain, no numbness
Frequent pain, severe numbness
Severe pain and numbness
Walking Ability
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Walking Ability
Normal walking
Pain, numbness, or weakness after 500m
Walking limit within 100-500m
Within 100m
Objective Examination
Straight Leg Raise Test (including hamstrings)
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Straight Leg Raise Test (including hamstrings)
Normal
30°~70°
Less than 30°
Sensation
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Sensation
Normal
Mild sensory impairment
Severe sensory impairment
Muscle Strength Decline (MRC grading)
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Muscle Strength Decline (MRC grading)
Normal (5)
Mild muscle weakness (4)
Severe muscle weakness (3~0)
Daily Activity Limitation (ADL)
Turning Over in Bed
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Turning Over in Bed
Normal
Mild limitation
Severe limitation
Standing
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Standing
Normal
Mild limitation
Severe limitation
Washing
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Washing
Normal
Mild limitation
Severe limitation
Forward Bending
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Forward Bending
Normal
Mild limitation
Severe limitation
Sitting (about 1 hour)
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Sitting (about 1 hour)
Normal
Mild limitation
Severe limitation
Lifting Heavy Objects
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Lifting Heavy Objects
Normal
Mild limitation
Severe limitation
Walking
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Walking
Normal
Mild limitation
Severe limitation
Bladder Function
Bladder Function
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Bladder Function
Normal
Mild limitation
Severe limitation (urinary retention, incontinence)
Score:

Result Interpretation

The total JOA score ranges from 0 to 29 points, with lower scores indicating more severe functional impairment. Improvement index = [post-treatment score - pre-treatment score] / post-treatment score. Improvement rate = [post-treatment score - pre-treatment score] / [normal - pre-treatment score] × 100%.

The improvement index reflects the improvement in lumbar function before and after treatment, and the improvement rate indicates the clinical treatment effect. The improvement rate also corresponds to the commonly used efficacy evaluation criteria: 100% improvement rate indicates cure, >60% indicates significant effect, 25-60% indicates effective, and <25% indicates ineffective.

English name: JOA score rating system for low back pain.

References

Research Paper Izumida S, Inoue S. Assessment of treatment for low back pain. J Jpn Orthop Assoc 1986;60:391–4 (in Japanese).
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