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采用改良德尔菲法建立新的神经根型颈椎病治疗的中国临床共识。

Using the modified Delphi method to establish a new Chinese clinical consensus of the treatments for cervical radiculopathy.

作者信息

Zang Lei, Fan Ning, Hai Yong, Lu S B, Su Q J, Yang J C, Du Peng, Gao Y J

机构信息

Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, GongTiNanLu 8#, Chaoyang district, 100020, Beijing, China.

出版信息

Eur Spine J. 2015 Jun;24(6):1116-26. doi: 10.1007/s00586-015-3856-7. Epub 2015 Mar 10.

Abstract

PURPOSE

Although cervical radiculopathy is very common, there is no standard treatment for this condition, with little high-level evidence available to guide the treatment choice. Thus, this study aimed to review the current data on the management of cervical radiculopathy; and, further, to establish a new Chinese clinical consensus of the treatments for cervical radiculopathy using the Delphi method.

METHODS

First, a systematic review of the previously established treatment guidelines and of articles related to cervical radiculopathy was conducted to establish a protocol for the clinical consensus of the treatment for cervical radiculopathy. Second, from February 2012 to June 2014, we performed a modified Delphi survey in which the current professional opinions from 30 experienced experts, representing almost all of the Chinese provinces, were gathered. Three rounds were performed, and consensus was defined as ≥70% agreement.

RESULTS

Consensus of the treatments for cervical radiculopathy was reached on seven aspects, including the proportion of patients requiring only non-surgical therapies; the effectiveness of neck immobilization, physiotherapy, pharmacologic treatment; surgical indications; contraindications; surgery.

CONCLUSIONS

The modified Delphi study conducted herein reached a consensus concerning several treatment issues for cervical radiculopathy. In the absence of high-level evidence, at present, these expert opinion findings will help guide health care providers to define the appropriate treatment in their regions. Items with no consensus provide excellent areas for future research.

摘要

目的

尽管颈椎神经根病非常常见,但对于这种疾病尚无标准治疗方法,几乎没有高级别证据可用于指导治疗选择。因此,本研究旨在回顾颈椎神经根病治疗的现有数据;此外,采用德尔菲法建立颈椎神经根病治疗的新的中国临床共识。

方法

首先,对先前制定的治疗指南和与颈椎神经根病相关的文章进行系统回顾,以建立颈椎神经根病治疗临床共识的方案。其次,从2012年2月至2014年6月,我们进行了一项改良的德尔菲调查,收集了代表中国几乎所有省份的30位经验丰富的专家的当前专业意见。共进行了三轮,共识定义为≥70%的同意率。

结果

在七个方面达成了颈椎神经根病治疗的共识,包括仅需非手术治疗的患者比例;颈部固定、物理治疗、药物治疗的有效性;手术指征;禁忌症;手术。

结论

本文进行的改良德尔菲研究就颈椎神经根病的几个治疗问题达成了共识。在缺乏高级别证据的情况下,目前,这些专家意见结果将有助于指导医疗服务提供者在其所在地区确定适当的治疗方法。未达成共识的项目为未来研究提供了很好的领域。

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