Outcome in patients with cervical radiculopathy - Prospective, multicenter study with independent clinical review
Outcome in patients with cervical radiculopathy - Prospective, multicenter study with independent clinical review
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DOI：
10.1097/00007632-199903150-00021
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发表时间：
1999-03-15
期刊：
影响因子：
3
通讯作者：
Ducker, T
中科院分区：
文献类型：
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作者：
Sampath, P;Bendebba, M;Ducker, T
研究设计.颈椎研究协会的研究是一项前瞻性、非随机、多中心的颈椎病和椎间盘疾病患者的研究。在本分析中，仅考虑了以神经根病为主要症状而无脊髓病的患者。确定症状性神经根病患者的人口统计学资料、外科医生的治疗实践和结局。背景资料摘要。目前尚不存在关于患者人口统计学和外科医生治疗实践的数据。目前还没有发表的前瞻性研究，其中的结果，包括疼痛，功能，神经症状，并进行日常生活活动的能力，是系统的量化。患者由参与颈椎研究协会的外科医生招募。人口统计学、病理学和功能性患者数据来自于初次检查时完成的患者和医生调查，结果来自于治疗后完成的患者调查。数据由盲法第三方进行汇总和统计分析。在41名CSRS外科医生入组的503名患者中，246名（49%）患有神经根病。患者的平均症状持续时间为26.7个月（范围：8周至>352个月），平均年龄为48.1 ± 12.42岁; 44.7%为女性。这些患者中有86例（35%）建议手术。在有随访数据的155名患者中，51名（33%）接受了手术，104名（67%）接受了药物治疗。手术治疗的患者在疼痛、神经症状、功能状态和日常生活活动能力方面有显著改善。大量接受手术的患者在随访时报告持续的剧痛或可怕的疼痛（26%）。药物治疗的患者在疼痛和整体功能状态方面也有显着改善。总之，这项研究是第一次对颈椎病和椎间盘源性神经根病患者进行深入的前瞻性结局分析。
Study Design. The Cervical Spine Research Society study is a prospective, nonrandomized, multicenter investigation of patients with cervical spondylosis and disc disease. In this analysis, only patients who had radiculopathy without myelopathy as the predominant symptom were considered.Objectives. To determine demographics, surgeon treatment practices, and outcomes in patients with symptomatic radiculopathy.Summary of Background Data. Current data on patient demographics and treatment practices of surgeons do not exist. There are no published prospective studies in which outcomes, including pain, function, neurologic symptoms, and ability to perform activities of daily living, are systematically quantified.Methods. Patients were recruited by participating Cervical Spine Research Society surgeons. Demographic, symptomologic, and functional patient data were compiled from surveys of patients and physicians completed at the time of initial examination, and outcomes were assessed from surveys of patients completed after treatment. Data were compiled and statistically analyzed by a blinded third party.Results. Of the 503 patients enrolled by 41 CSRS surgeons, 246 (49%) had radiculopathy. Patients had a mean duration of symptoms of 26.7 months (range, 8 weeks to >352 months) and a mean age of 48.1 +/- 12.42 years; 44.7% were female. Surgery was recommended for 86 (35%) of these patients. Of the 155 patients on whom there were follow-up data, 51 (33%) underwent surgery, whereas 104 (67%) received medical treatment. Surgically treated patients had a significant improvement in pain, neurologic symptoms, functional status, and ability to perform activities of daily living. A significant number of patients who underwent surgery reported persistent excruciating or horrible pain on follow-up (26%). Patients treated medically also had significant improvement in pain and overall functional status.Conclusions. In summary, this study represents the first in-depth, prospective outcome analysis of patients with cervical spondylotic and discogenic radiculopathy.