Conservative treatment versus surgery in spondylotic cervical myelopathy: a prospective randomised study
Jazyk angličtina Země Německo Médium print
Typ dokumentu klinické zkoušky, srovnávací studie, časopisecké články, randomizované kontrolované studie, práce podpořená grantem
PubMed
11189924
PubMed Central
PMC3611417
DOI
10.1007/s005860000132
Knihovny.cz E-zdroje
- MeSH
- antiflogistika nesteroidní terapeutické užití MeSH
- komprese míchy etiologie rehabilitace chirurgie MeSH
- krční obratle diagnostické zobrazování zranění chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- obnova funkce MeSH
- osteofytóza páteře komplikace rehabilitace chirurgie MeSH
- pooperační komplikace etiologie MeSH
- posuzování pracovní neschopnosti MeSH
- progrese nemoci MeSH
- prospektivní studie MeSH
- radiografie MeSH
- tolerance zátěže MeSH
- výsledek terapie MeSH
- výztuhy MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
- Názvy látek
- antiflogistika nesteroidní MeSH
A prospective randomised 2-year study was performed to compare the conservative and operative treatment of mild and moderate forms of spondylotic cervical myelopathy (SCM). Forty-eight patients presenting with the clinical syndrome of SCM, with a modified Japanese Orthopaedic Association (mJOA) score of 12 points or more, were randomised into two groups. Group A, treated conservatively, consisted of 27 patients, mean age 55.6 +/- 8.6 years, while group B was treated surgically (21 patients, mean age 52.7 +/- 8.1 years). The clinical outcome was measured by the mJOA score, recovery rate (RR), timed 10 m walk, score of daily activities (recorded by video and evaluated by two observers blinded to the therapy), and by the subjective assessment of the patients at 6, 12, and 24 months of the follow-up. There was, on average, no significant deterioration in mJOA score, recovery ratio, or timed 10 m walk within either group during the 2 years of follow-up. In the surgery group there was a slight decline in the scores for daily activities and subjective evaluation. A comparison of the two groups showed no significant differences in changes over time in mJOA score or quantified gait, but there were significant differences in the score of daily activities recorded by video at 24 months, which was a little lower in the surgical group, and also in RR and subjective evaluation, which were both worse in the surgical group at months 12 and 24. However, at month 6, this last parameter was significantly better in the surgical than in conservative group. Surgical treatment of mild and moderate forms of SCM in the present study design, comprising the patients with no or very slow, insidious progression and a relatively long duration of symptoms, did not show better results than conservative treatment over the 2-year follow-up.
Citace poskytuje Crossref.org
Cervical spondylotic myelopathy: conservative versus surgical treatment after 10 years