Approaches to spondylotic cervical myelopathy -: Conservative versus surgical results in a 3-year follow-up study
Approaches to spondylotic cervical myelopathy -: Conservative versus surgical results in a 3-year follow-up study
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DOI：
10.1097/00007632-200210150-00003
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发表时间：
2002-10-15
期刊：
影响因子：
3
通讯作者：
Dusek, L
中科院分区：
文献类型：
--
作者：
Kadanka, Z;Mares, M;Dusek, L
研究设计.进行了一项为期3年的前瞻性随机研究。比较保守治疗和手术治疗轻、中度、非进展型和缓慢进展型脊髓型颈椎病的疗效。目前尚不清楚减压手术治疗轻、中度脊髓型颈椎病的结果是否优于保守治疗。在这项研究中，68名患者被随机分为两组。A组为保守治疗组，共35例; B组为手术治疗组，共33例。在随访6、12、24和36个月时，通过改良的乔亚评分、定时10 m步行、视频记录的日常活动评分（由两名对治疗类型不知情的观察者进行评估）以及患者自己的主观评估来评估临床结局。平均而言，在3年随访期间，两组的mJOA评分没有显著恶化，但B组的自我评价评分略有下降，A组。两组比较显示，A组在计时10 m步行试验方面有显著性差异，但在mJOA评分和患者自我评价方面无差异，但在6个月时评分优于B组。3年的随访研究没有显示，平均而言，手术上级保守治疗的轻度和中度形式的脊髓型颈椎病。
Study Design. A 3-year prospective randomized study was conducted.Objective. To compare conservative and operative treatments of mild and moderate, nonprogressive, and slowly progressive forms of spondylotic cervical myelopathy.Summary of Background Data. It is not known whether the results of decompressive surgery for the mild and moderate forms of spondylotic cervical myelopathy are any better than those of the conservative approach.Methods. For this study, 68 patients were randomized into two groups. Group A, treated conservatively, consisted of 35 subjects, whereas Group B, treated surgically, was composed of 33 patients. The clinical outcome was evaluated by modified JOA score, timed 10-m walk, the score for daily activities recorded by video and evaluated by two observers blinded to the type of therapy, and subjective assessment by the patients themselves at months 6, 12, 24, and 36 of the follow-up period.Results. There was, on the average, no significant deterioration in mJOA score in the two groups over the 3-year follow-up period, but there was a slightly expressed decrease in the self-evaluation score in Group B, Group A. Comparison of the two groups showed a significant difference in the timed 10-m walk test favoring group A, but no difference in mJOA score or self-evaluation by the patients themselves, with the exception of a better score at month 6 in favor of Group B.Conclusions. The 3-year follow-up study did not show, on the average, that the surgery is superior to conservative treatment for mild and moderate forms of spondylotic cervical myelopathy.