Long-lasting cervical radicular pain managed with surgery, physiotherapy, or a cervical collar - A prospective, randomized study
Long-lasting cervical radicular pain managed with surgery, physiotherapy, or a cervical collar - A prospective, randomized study
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DOI：
10.1097/00007632-199704010-00007
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发表时间：
1997-04-01
期刊：
影响因子：
3
通讯作者：
Carlsson, JY
中科院分区：
文献类型：
--
作者：
Persson, LCG;Carlsson, CA;Carlsson, JY
研究设计.这项前瞻性随机研究比较了手术和保守治疗对长期颈神经根性疼痛患者的疗效。比较手术、物理治疗和颈托的效果。以前没有对照研究比较神经根性颈痛患者的手术治疗和非手术治疗。研究组包括81例持续时间至少3个月的颈臂疼痛患者，其中手臂疼痛的分布对应于通过磁共振成像或计算机断层扫描脊髓造影证实的因脊椎侵犯而显著受压的神经根，伴或不伴额外的椎间盘突出。患者被随机分配到手术（Cloward技术），个性化的物理治疗，或颈颈圈。通过视觉模拟量表评估疼痛强度，通过疾病影响特征评估功能，通过情绪形容词检查表评估情绪。分别在治疗前（对照1）、治疗后不久（对照2）和治疗后12个月（对照3）进行测量。在对照组1中，各组是均匀的。在中心2，手术组报告疼痛更少（视觉模拟量表），并且与物理治疗组一样，功能更好（疾病影响曲线）。在对照组3中，各组之间的视觉模拟量表、疾病影响特征和情绪形容词检查表测量结果没有差异。在治疗长期颈神经根性疼痛的患者时，颈托、理疗或手术似乎在长期内同样有效。
Study Design. This prospective, randomized study compares the efficacy of surgical and conservative treatments in patients with long-lasting cervical radicular pain.Objectives. To compare the effects of surgery, physiotherapy, and a cervical collar.Summary of Background Data. There are no previous controlled outcome studies that have compared surgical treatment with nonsurgical treatment of patients with cervical radicular pain.Methods. The study group comprised 81 patients with cervicobrachial pain of at least 3 months' duration, in whom the distribution of the arm pain corresponded to a nerve root that was significantly compressed by spondylotic encroachment with or without an additional bulging disc, as verified by magnetic resonance imaging or computed tomographic myelography. The patients were randomly allocated to surgery (Cloward technique), individually adapted physiotherapy, or a cervical collar. The therapeutic effects were evaluated with respect to pain intensity by the visual analogue scale, function by the Sickness Impact Profile, and mood by the Mood Adjective Check List. The measurements were performed before treatment (control 1), shortly after treatment (control 2), and after a further 12 months (control 3).Results. At control 1, the groups were uniform. At central 2, the surgery group reported less pain (visual analogue scale) and, like the physiotherapy group, better function (Sickness Impact Profile) than the collar group. At control 3, there was no difference in visual analogue scale, Sickness Impact Profile, and Mood Adjective Check List measurements among the groups.Conclusions. In the treatment of patients with long-lasting cervical radicular pain, it appears that a cervical collar, physiotherapy, or surgery are equally effective in the long term.