Pediatric modification of the Japanese Orthopedic Association scale

Abstract

Objective. To perform clinical testing of a pediatric modification of the 18-point Japanese Orthopedic Association (mJOA) scale for assessing pathology of the spine and spinal cord in children.Material and Methods. Functional and neurological status was assessed in 143 pediatric patients with pathology of the spine and spinal cord using the mJOA scale with three age versions (0.5–1.5 years, 1.5–4 years and 4–18 years). The control group included 10 adult patients with a similar pathology profile, who were assessed using the mJOA scale as modified by Benzel.Results. An initial analysis of mJOA scores across five age groups (0.5–1.5, 1.5–4, 4–8, 8–18, and over 18 years) did not reveal significant differences in final scores. Repeat assessment (mean 3.1 years, range 1–10 years) also showed no significant differences either withinor between groups. A secondary analysis was performed in patients with pathology at the cervical, thoracic and lumbar levels of the spinal cord: no significant changes in scale scores were found within the groups over time. At the same time, patients with pathology at thecervical level demonstrated a significantly higher score; they were less likely to have deformity of the lower extremities and dependence on a wheelchair, while sensitivity and movements in the upper extremities were significantly worse than in other groups.Conclusion. The proposed pediatric mJOA scale demonstrated age consistency and utility. The results of assessing the functional and neurological state of patients using this scale, in addition to being comparable with each other, are comparable with the results of the Benzel mJOA scale in adults.