Holly Langston T, Matz Paul G, Anderson Paul A, Groff Michael W, Heary Robert F, Kaiser Michael G, Mummaneni Praveen V, Ryken Timothy C, Choudhri Tanvir F, Vresilovic Edward J, Resnick Daniel K
Division of Neurosurgery, David Geffen School of Medicine, University of California at Los Angeles, California, USA.
J Neurosurg Spine. 2009 Aug;11(2):238-44. doi: 10.3171/2009.2.SPINE08715.
The objective of this systematic review was to use evidence-based medicine to identify valid, reliable, and responsive measures of functional outcome after treatment for cervical degenerative disease.
The National Library of Medicine and Cochrane Database were queried using MeSH headings and key words relevant to functional outcomes. Abstracts were reviewed after which studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons.
Myelopathy Disability Index, Japanese Orthopaedic Association scale, 36-Item Short Form Health Survey, and gait analysis were found to be valid and reliable measures (Class II) for assessing cervical spondylotic myelopathy. The Patient-Specific Functional Scale, the North American Spine Society scale, and the Neck Disability Index were found to be reliable, valid, and responsive (Class II) for assessing radiculopathy for nonoperative therapy. The Cervical Spine Outcomes Questionnaire was a reliable and valid method (Class II) to assess operative therapy for cervical radiculopathy.
Several functional outcome measures are available to assess cervical spondylotic myelopathy and cervical radiculopathy.
本系统评价的目的是运用循证医学方法，确定用于评估颈椎退行性疾病治疗后功能转归的有效、可靠且具反应性的指标。
使用与功能转归相关的医学主题词和关键词检索美国国立医学图书馆及考克兰数据库。对摘要进行评审后，选取符合纳入标准的研究。指南制定小组编制了一个证据表，总结证据质量（I - III级）。关于证据水平的分歧通过专家共识会议解决。该小组根据苏格兰校际指南网络制定了包含推荐强度的建议。通过美国神经外科医师协会/神经外科医师大会联合指南委员会的同行评审进行验证。
脊髓病残疾指数、日本矫形外科学会评分、简明健康状况调查36项问卷及步态分析被发现是评估脊髓型颈椎病的有效且可靠的指标（II级）。患者特异性功能量表、北美脊柱协会评分及颈部残疾指数被发现对于评估非手术治疗的神经根病是可靠、有效且具反应性的（II级）。颈椎功能预后问卷是评估神经根型颈椎病手术治疗的一种可靠且有效的方法（II级）。
有多种功能转归指标可用于评估脊髓型颈椎病和神经根型颈椎病。
