Department of Orthopedic Surgery, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115-6110, USA.
Spine J. 2011 Jan;11(1):64-72. doi: 10.1016/j.spinee.2010.10.023.
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.
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.
Systematic review and evidence-based clinical guideline.
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.
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.
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.
北美脊柱学会（NASS）基于退行性疾病的颈椎神经根病诊断与治疗循证临床指南为退行性疾病所致颈椎神经根病的诊断与治疗提供了关键临床问题的循证建议。该指南基于截至 2009 年 5 月为止，与该主题相关的最高质量的临床文献来解决这些问题。该指南的建议有助于从业者为这种常见疾病提供最佳的有效治疗和功能恢复。
提供一个循证教育工具，以帮助脊柱护理提供者提高为退行性疾病所致颈椎神经根病患者提供的护理质量和效率。
系统回顾和循证临床指南。
本报告来自 NASS 循证临床指南制定委员会的颈椎神经根病退行性疾病工作组。工作组由接受过循证分析原则培训的多学科脊柱护理专家组成。小组的每位成员都制定了一系列临床问题，供小组讨论。小组最终同意的问题是本报告的主题。使用特定的搜索协议，对 MEDLINE、EMBASE（药物与药理学）和另外四个循证数据库中发现的英文参考文献进行了有关每个问题的文献搜索。然后由至少三名审阅者独立使用 NASS 采用的标准化证据等级对相关文献进行评分。为每个问题创建了一个证据表。通过工作组讨论得出回答每个临床问题的最终建议，并使用标准化的推荐等级为建议分配等级。在缺乏 I 至 IV 级证据的情况下，使用改良的名义群体技术制定了工作组共识陈述，并且在指南中明确指出了这些陈述。
制定了 18 个临床问题，涉及退行性疾病颈椎神经根病的自然病史、诊断和治疗。本文总结了这些答案。根据支持文献的强度对相应的建议进行了分级，该文献按证据水平分层。
使用循证医学和最佳现有证据的技术为退行性疾病颈椎神经根病创建了临床指南，以帮助从事这种疾病护理的从业者和患者。整个指南文件，包括证据表、对未来研究的建议以及所有参考文献，均可在 NASS 网站（www.spine.org）上以电子方式获取，并将按计划及时更新。
