Yoshimatsu H, Nagata K, Goto H, Sonoda K, Ando N, Imoto H, Mashima T, Takamiya Y
Department of Orthopaedic Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Fukuoka, Japan.
Spine J. 2001 Jul-Aug;1(4):269-73. doi: 10.1016/s1529-9430(01)00082-1.
Many studies have suggested only slight effects of conservative treatment on cervical spondylotic myelopathy (CSM), whereas a few reports describe conservative treatment as being effective. This suggested the influence of various factors on treatment outcomes.
We investigated symptomatic changes after conservative treatment in patients based on a clear understanding of the effects and limitations of conservative treatment.
We have encountered cases that showed symptomatic improvement with conservative treatment and became interested in the effectiveness of conservative treatment for CSM and whether other factors affect the results of conservative treatment.
We have analyzed the results of conservative treatment for CSM in 69 cases, derived from a population of 101 CSM cases.
Symptoms at the time of the first examination were compared with those at the final examination, and the patients were classified into three groups showing improvement, no change or exacerbation.
Improvement or exacerbation of the symptoms was used as dependent variables and the collected factors as independent variables, and logistic regression was performed on these variables.
Multivariate analysis showed significant correlation between clinical outcome and the disease duration and the presence of rigorous conservative treatment.
Conservative treatment for CSM is considered to be effective if it is performed intensively in selected patients. In treating CSM, the therapeutic approach must be selected first in consideration of the patient's disease duration. Conservative treatment must be carried out intensively after sufficient explanation to the patients. Timely surgical intervention is considered to be important if the symptoms show no change or exacerbation with conservative treatment.
许多研究表明保守治疗对脊髓型颈椎病（CSM）仅有轻微效果，而少数报告称保守治疗有效。这表明多种因素对治疗结果有影响。
在清楚了解保守治疗的效果和局限性的基础上，我们调查了保守治疗后患者的症状变化。
我们遇到了一些经保守治疗症状改善的病例，并对CSM保守治疗的有效性以及其他因素是否影响保守治疗结果产生了兴趣。
我们分析了101例CSM患者中69例的保守治疗结果。
将首次检查时的症状与末次检查时的症状进行比较，患者被分为症状改善、无变化或加重三组。
将症状的改善或加重作为因变量，收集的因素作为自变量，对这些变量进行逻辑回归分析。
多因素分析显示临床结果与病程以及是否进行严格的保守治疗之间存在显著相关性。
如果对选定的患者进行强化保守治疗，CSM保守治疗被认为是有效的。在治疗CSM时，必须首先根据患者的病程选择治疗方法。在向患者充分解释后，必须进行强化保守治疗。如果保守治疗后症状无变化或加重，及时进行手术干预被认为很重要。
