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All three approaches were applied to the patients. 3. CNFDS The CNFDS (Appendix 1) is designed to evaluate the disability experienced by CSM patients. It is a self-administered questionnaire that consists of three sections including 15 items that evaluates the impact of neck pain including the patient's perception of the future impact of neck pain (3 items including 1, 5, and 15), disability during everyday activities (9 items including items 2, 3, 4, 5, 7, 8, 9, 10 and 12) and social interaction and recreation (5 items including item 6, 9, 11, 13 and 14). Each item has three possible response categories (yes=0, [http://www.selleckchem.com/products/cx-5461.html see more] occasionally=1 and no=2) for the first 5 items and the remaining items are scored in the reverse (yes=2, occasionally=1 and no=0). The total score ranges from 0 to 30, with higher score indicating greater disability [17]. 4. mJOA The Iranian version of the mJOA was simultaneously administered to patients. It is a self-administered, [http://www.selleckchem.com/products/forskolin.html cAMP inhibitor] disease-specific tool modified from the JOA score [8,9] that consists of four sections including 22 items: motor dysfunction of the upper extremities (6 items), motor dysfunction of the lower extremities (8 items), sensation (4 items) and sphincter dysfunction (4 items). The score the respective section ranges from 0 to 5, 0 to 7, 0 to 3 and 0 to 3, giving a total score ranging from 0 to 18. Higher scores indicate less disability. In this study the total mJOA was calculated for assessment. In a previous study by this group, the Iranian version of mJOA was documented as a reliable and valid measure of motor, sensory and sphincter dysfunctions among CSM patients [9]. Patients were assessed preoperatively and postoperatively. CNFDS and mJOA scoring were completed at the same time on the day before surgery and at the end of follow-up. The recovery rate of mJOA score (%) was also assessed using a previously published formula [20]: recovery rate (%)=[postoperative score�Cpreoperative [https://en.wikipedia.org/wiki/Dipivefrine Dipivefrine] score]/[full score (18)�Cpreoperative score]��100. 5. Statistical analyses Statistical analyses were performed using PASW ver. 18.0 (SPSS Inc., Chicago, IL, USA). A p-value of