PONE-D-20-32795

Epidemiological study on cervical cord compression and its clinical symptoms in community-dwelling residents

PLOS ONE

Dear Dr. Hirai,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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We look forward to receiving your revised manuscript.

Kind regards,

Gregory W.J. Hawryluk, MD, PhD, FRCSC

Academic Editor

PLOS ONE

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4. Please provide a sample size and power calculation in the Methods, or discuss the reasons for not performing one before study initiation.

5. Please include additional information regarding the survey or questionnaire used in the study and ensure that you have provided sufficient details that others could replicate the analyses. For instance, if you developed a questionnaire as part of this study and it is not under a copyright more restrictive than CC-BY, please include a copy, in both the original language and English, as Supporting Information.

6.Thank you for stating the following in the Source of funding Section of your manuscript:

"study was supported by a grant from the Fukushima Society for the

Promotion of Medicine and a grant from the Fukushima Prefectural Hospitals. These

grants were mainly used for the cost of the MRI, research assistance, and printing and

posting the questionnaire."

We note that you have provided funding information that is not currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form.

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 "unfunded studies"

Please include your amended statements within your cover letter; we will change the online submission form on your behalf.

7. Please amend the manuscript submission data (via Edit Submission) to include author Koji Otani, MD, DMSc, Miho Sekiguchi, MD, PhD, Shin-ichi Kikuchi, MD, PhD, and Shin-ichi Konno.

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Additional Editor Comments:

There seems to have been a problem with the ability of the reviewers to access the manuscript for review. I am cognizant of the lengthy wait to get this manuscript reviewed. I think it would be fair to have the authors address the revisions suggested by Reviewer #2 and to re-engage reviewer #1 at that time as opposed to now taking on an anticipated lengthy delay to get feedback from another reviewer.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: No

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: No

Reviewer #2: No

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors have submitted what appears to be figures and graphs but no actual manuscript body. It is impossible to evaluate the quality of data without this. Hopefully this material will be provided at some point.

Reviewer #2: This is an interesting and relevant topic. The relationship between cord compression and clinical signs and symptoms is of increasing importance as this problem becomes more prevalent in the aging population. However there are some concerns:

1) It is not clear how novel this study is. Many of the references are somewhat dated. The introduction refers to "numerous studies" and that the "relationship remains unclear". This doesn't really demonstrate why this study is any different than any of the other "numerous studies" besides adding incrementally to the literature.

2) While the English and grammar are not terrible, there are areas where the grammar and use of non-scientific language could be improved.

3) It wasn't clear to me whether the examining surgeon was blinded to the MRI results at the time of examination.

4) There is a missed opportunity here to also examine cumulative compression. The data are all there, the statistics just need to be run.

5) For the AP diameter measurement, it is not clear how many radiologists were utilized to obtain the intra and inter-observer reliability. Then this was deemed "acceptable" and only one radiologist's measurements were utilized. It is unclear whether this reliability was pre-determined or was determined using the data for this study. If more than one radiologist read for this study, why not average their readings for more accuracy and input? More information could be provided here.

Overall, there are some interesting findings here, but needs some revision.

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Reviewer #1: No

Reviewer #2: Yes: Ann M. Parr

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Epidemiological study on cervical cord compression and its clinical symptoms in community-dwelling residents

PONE-D-20-32795R1

Dear Dr. Otani,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Gregory W.J. Hawryluk, MD, PhD, FRCSC

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Thank you for addressing the reviewer critiques.

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: (No Response)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: No