Gamble, ARAnderson, DBMcKay, MJDavies, BMacpherson, SVan Gelder, JHoffmann, TMcCaffery, KStevens, SXAmmendolia, CChauhan, RVZipser, CMBoerger, TFTetreault, LAFehlings, MGDustan, ENugent, CHolmgren, HDemetriades, AKLantz, JMDhillon, RMaher, CGZadro, JR2026-05-152026-05-152026-04-03BMJ Open, ISSN: 2044-6055 (Print); 2044-6055 (Online), BMJ Publishing Group, 16(4), e106337-. doi: 10.1136/bmjopen-2025-1063372044-60552044-6055http://hdl.handle.net/10292/21091OBJECTIVES: To develop and user-test a patient decision aid for people diagnosed with degenerative cervical myelopathy and who are considering surgery. DESIGN: Mixed-methods study describing the development of a patient decision aid. SETTING: A draft decision aid was developed by a multidisciplinary steering group (including study authors with degenerative cervical myelopathy, health professionals and researchers) informed by the best available evidence, authorship consensus and existing patient decision aids. PARTICIPANTS: Patient-participants and health professional-participants who manage people with degenerative cervical myelopathy were recruited through social media and the steering group's research and practice network. Quantitative questionnaires were used to gather baseline data, descriptive feedback, refine the decision aid and assess its acceptability. Qualitative semi-structured interviews were conducted online to gather feedback on the decision aid and were analysed using reflexive thematic analysis. RESULTS: We conducted 32 interviews: 19 patient-participants and 13 health professional-participants who manage people with degenerative cervical myelopathy (neurosurgeons, neurologists, physiotherapists, orthopaedic surgeons, general practitioners, rehabilitation and pain specialists and consultant occupational physicians and chiropractors). Participants were from 10 countries (Australia, Canada, Cyprus, Germany, Ireland, New Zealand, Sweden, Switzerland, United Kingdom and USA). Most participants rated the decision aid's acceptability as good-to-excellent and agreed with most aspects of the decision aid (eg, defining degenerative cervical myelopathy, management recommendations, potential benefits and harms, questions to consider asking a health professional). CONCLUSION: Our patient decision aid was rated as an acceptable tool by both health professional-participants who treat degenerative cervical myelopathy and patient-participants with lived experience of degenerative cervical myelopathy. This decision aid can be used by clinicians and people with degenerative cervical myelopathy to help with shared decision making following a diagnosis of degenerative cervical myelopathy. A study testing the potential benefits of this decision aid in a clinical setting is recommended.This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.https://creativecommons.org/licenses/by/4.0/NeurosurgeryOrthopedicsSpine32 Biomedical and Clinical Sciences4201 Allied Health and Rehabilitation Science4203 Health Services and Systems3202 Clinical Sciences42 Health SciencesClinical Research7.3 Management and decision makingMusculoskeletal3 Good Health and Well Being1103 Clinical Sciences1117 Public Health and Health Services1199 Other Medical and Health Sciences32 Biomedical and clinical sciences42 Health sciences52 PsychologyHumansDecision Support TechniquesSpinal Cord DiseasesMaleCervical VertebraeFemalePatient ParticipationQualitative ResearchMiddle AgedSurveys and QuestionnairesInterviews as TopicAgedAdultCervical VertebraeHumansSpinal Cord DiseasesDecision Support TechniquesQualitative ResearchAdultAgedMiddle AgedPatient ParticipationFemaleMaleInterviews as TopicSurveys and QuestionnairesJournal ArticleOpenAccess10.1136/bmjopen-2025-106337