An evidence-based clinical guideline for the diagnosis and treatment of cervical radiculopathy from degenerative disorders

被引:285
作者
Bono, Christopher M. [1 ]
Ghiselli, Gary [2 ]
Gilbert, Thomas J. [3 ]
Kreiner, D. Scott [4 ]
Reitman, Charles [5 ]
Summers, Jeffrey T. [6 ]
Baisden, Jamie L. [7 ]
Easa, John [8 ]
Fernand, Robert [9 ]
Lamer, Tim [10 ]
Matz, Paul G. [11 ]
Mazanec, Daniel J. [12 ]
Resnick, Daniel K. [13 ]
Shaffer, William O. [14 ]
Sharma, Anil K. [15 ,16 ]
Timmons, Reuben B. [17 ]
Toton, John F.
机构
[1] Brigham & Womens Hosp, Dept Orthoped Surg, Boston, MA 02115 USA
[2] DenverSpine, Greenwood Village, CO 80111 USA
[3] Ctr Diagnost Imaging, St Louis Pk, MN 55416 USA
[4] Ahwatukee Sports & Spine, Phoenix, AZ 85048 USA
[5] Baylor Clin, Houston, TX 77030 USA
[6] NewSouth NeuroSpine, Flowood, MS 39232 USA
[7] Med Coll Wisconsin, Dept Neurosurg, Milwaukee, WI 53226 USA
[8] Ctr Adv Intervent Spine Treatment, Holland, MI 49424 USA
[9] N Jersey Med Village, Wayne, NJ 07470 USA
[10] Mayo Clin, Rochester, MN 55905 USA
[11] Neurosurg & Neurol LLC, Chesterfield, MO 63017 USA
[12] Cleveland Clin, Ctr Spine, Cleveland, OH 44195 USA
[13] Univ Wisconsin, Sch Med, Dept Neurosurg, Madison, WI 53792 USA
[14] Joint & Sports Surg, NW Iowa Bone, Spencer, IA 51301 USA
[15] Spine & Pain Ctr NJ, Little Silver, NJ 07739 USA
[16] Spine & Pain Ctr NY, Little Silver, NJ 07739 USA
[17] Comprehens Pain Med, Pensacola, FL 32503 USA
基金
美国国家卫生研究院;
关键词
Diagnosis; Imaging; Treatment; Cervical radiculopathy from degenerative disorders; Clinical practice guideline; NERVE ROOT BLOCK; TRANSFORAMINAL STEROID INJECTIONS; SURGICALLY TREATED PATIENTS; TERM-FOLLOW-UP; NECK PAIN; NONOPERATIVE MANAGEMENT; ANTERIOR DISKECTOMY; DISK HERNIATION; PLATE FIXATION; RADICULAR PAIN;
D O I
10.1016/j.spinee.2010.10.023
中图分类号
R74 [神经病学与精神病学];
学科分类号
100204 [神经病学];
摘要
BACKGROUND CONTEXT: The North American Spine Society (NASS) Evidence-Based Clinical Guideline on the Diagnosis and Treatment of Cervical Radiculopathy from Degenerative Disorders provides evidence-based recommendations on key clinical questions concerning the diagnosis and treatment of cervical radiculopathy from degenerative disorders. The guideline addresses these questions based on the highest quality clinical literature available on this subject as of May 2009. The guideline's recommendations assist the practitioner in delivering optimum efficacious treatment of and functional recovery from this common disorder. PURPOSE: Provide an evidence-based educational tool to assist spine care providers in improving quality and efficiency of care delivered to patients with cervical radiculopathy from degenerative disorders. STUDY DESIGN: Systematic review and evidence-based clinical guideline. METHODS: This report is from the Cervical Radiculopathy from Degenerative Disorders Work Group of the NASS' Evidence-Based Clinical Guideline Development Committee. The work group consisted of multidisciplinary spine care specialists trained in the principles of evidence-based analysis. Each member of the group formatted a series of clinical questions to be addressed by the group. The final questions agreed on by the group are the subjects of this report. A literature search addressing each question using a specific search protocol was performed on English language references found in MEDLINE, EMBASE (Drugs and Pharmacology), and four additional evidence-based databases. The relevant literature was then independently rated by a minimum of three reviewers using the NASS-adopted standardized levels of evidence. An evidentiary table was created for each of the questions. Final recommendations to answer each clinical question were arrived at via work group discussion, and grades were assigned to the recommendations using standardized grades of recommendation. In the absence of Levels I to IV evidence, work group consensus statements have been developed using a modified nominal group technique, and these statements are clearly identified as such in the guideline. RESULTS: Eighteen clinical questions were formulated, addressing issues of natural history, diagnosis, and treatment of cervical radiculopathy from degenerative disorders. The answers are summarized in this article. The respective recommendations were graded by the strength of the supporting literature, which was stratified by levels of evidence. CONCLUSIONS: A clinical guideline for cervical radiculopathy from degenerative disorders has been created using the techniques of evidence-based medicine and best available evidence to aid both practitioners and patients involved with the care of this condition. The entire guideline document, including the evidentiary tables, suggestions for future research, and all references, is available electronically at the NASS Web site (www.spine.org) and will remain updated on a timely schedule. (C) 2011 Elsevier Inc. All rights reserved.
引用
收藏
页码:64 / 72
页数:9
相关论文
共 82 条
[1]
Alexandre A, 2005, ACT NEUR S, V92, P79
[2]
The value of neurophysiological and imaging studies in predicting outcome in the surgical treatment of cervical radiculopathy [J].
Alrawi, Mogdad F. ;
Khalil, Nofal M. ;
Mitchell, Piers ;
Hughes, Sean P. .
EUROPEAN SPINE JOURNAL, 2007, 16 (04) :495-500
[3]
Selective diagnostic cervical nerve root block -: correlation with clinical symptoms and MRI-pathology [J].
Anderberg, L ;
Annertz, M ;
Brandt, L ;
Säveland, H .
ACTA NEUROCHIRURGICA, 2004, 146 (06) :559-565
[4]
Transforaminal steroid injections for the treatment of cervical radiculopathy:: a prospective and randomised study [J].
Anderberg, Leif ;
Annertz, Marten ;
Persson, Liselott ;
Brandt, Lennart ;
Saveland, Hans .
EUROPEAN SPINE JOURNAL, 2007, 16 (03) :321-328
[5]
Distribution patterns of transforaminal injections in the cervical spine evaluated by multi-slice computed tomography [J].
Anderberg, Leif ;
Saveland, Hans ;
Annertz, Marten .
EUROPEAN SPINE JOURNAL, 2006, 15 (10) :1465-1471
[6]
Selective diagnostic nerve root block for the evaluation of radicular pain in the multilevel degenerated cervical spine [J].
Anderberg, Leif ;
Annertz, Marten ;
Rydholm, Urban ;
Brandt, Lennart ;
Saeveland, Hans .
EUROPEAN SPINE JOURNAL, 2006, 15 (06) :794-801
[7]
A comparison of magnetic resonance imaging and neurophysiological studies in the assessment of cervical radiculopathy [J].
Ashkan, K ;
Johnston, P ;
Moore, AJ .
BRITISH JOURNAL OF NEUROSURGERY, 2002, 16 (02) :146-148
[8]
Barlocher Christian B, 2002, Neurosurg Focus, V12, pE4, DOI 10.3171/foc.2002.12.1.5
[9]
A comparison of T2 and gadolinium enhanced MRI with CT myelography in cervical radiculopathy [J].
Bartlett, RJV ;
Hill, CR ;
Gardiner, E .
BRITISH JOURNAL OF RADIOLOGY, 1998, 71 (841) :11-19
[10]
Reliability of clinical tests in the assessment of patients with neck/shoulder problems -: Impact of history [J].
Bertilson, BC ;
Grunnesjö, M ;
Strender, LE .
SPINE, 2003, 28 (19) :2222-2231