Study Design: Case series. Objective: To compare transcranial magnetic stimulation (TMS) and magnetic resonance imaging (MRI) findings between patients who underwent surgery for cervical spondylotic myelopathy and those with spondylosis who were not operated upon, and to correlate these findings with clinical functionality at follow-up. Setting: Private practice. Methods: Of 16 consecutive patients with cervical spondylosis 8 underwent surgery (group I) and 8 were treated conservatively (group II). We compared TMS and MRI findings between these groups and we correlated central motor conduction times (CMCTs) and MRImeasured sagittal and parasagittal diameters of the spinal canal at baseline evaluation, with clinical functionality at 2-year follow-up. Results: Group I CMCTs at the lower limbs correlated significantly with modified-JoA 2 years post surgery (r = − 0.71, Po0.05), but MRI-measured diameters did not. In group II baseline TMS was unrevealing, contrary to significant spinal stenosis disclosed by MRI. The condition of none of these patients deteriorated at 2 years. Conclusions: CMCTs at the lower limbs, but not cervical spinal canal diameters, correlate with long-term functional outcome following surgical or conservative treatment. Spinal Cord (2015) 53, S16-S18; doi:10.1038/sc.2014.220 INTRODUCTIONWhether magnetic resonance imaging (MRI) and transcranial magnetic stimulation (TMS) can predict long-term clinical outcomes in patients with cervical spondylosis is an issue of debate. 1-3 We compared TMS and MRI findings between a group of patients who underwent surgery for cervical spondylotic myelopathy and a second group with spondylosis, who were not operated upon, and we correlated these abnormalities with longitudinal clinical follow-up.

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