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患者对神经根型颈椎病诊断与治疗的看法。

Patients' beliefs about diagnosis and treatment of cervical spondylosis with radiculopathy.

作者信息

Weber Clemens, Behbahani Maziar, Baardsen Roald, Lehmberg Jens, Meyer Bernhard, Shiban Ehab

机构信息

Department of Neurosurgery, Stavanger University Hospital, 4068, Stavanger, Norway.

Department of Neurosurgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.

出版信息

Acta Neurochir (Wien). 2017 Dec;159(12):2379-2384. doi: 10.1007/s00701-017-3356-0. Epub 2017 Oct 23.

Abstract

BACKGROUND

The clinical results of surgical spine care may be influenced by the patients' understanding and knowledge of his or her condition, treatment options and decision-making process. The aim of this survey study was to evaluate certain beliefs and opinions of patients with a degenerative condition in the cervical spine with a history of cervical radiculopathy such as importance of magnetic resonance imaging, risk factors, treatment alternatives and effectiveness.

METHODS

An anonymous questionnaire survey was performed on two different patient populations with a degenerative condition in the cervical spine with a history of cervical radiculopathy referred to the outpatients' clinics of two neurosurgical departments in Germany and Norway. The survey consisted of seven questions: four questions about the respondents' gender and age, history of previous spine surgery and/or conservative treatment for cervical disorder and three questions regarding the importance of imaging in the decision-making process, patients' willingness to undergo cervical surgery based on imaging findings even with few or no symptoms and the effectiveness of surgical or conservative treatment.

RESULTS

Two hundred eleven patients answered the questionnaire. Sixty-seven percent of all patients with a degenerative cervical condition believe that results from MRI studies are more important than clinical findings. Forty-seven percent were willing to undergo surgery based on MRI showing abnormalities even without or having few symptoms. Fifty percent believe that surgery is more effective in the treatment of axial neck pain.

CONCLUSION

Misbeliefs and misconceptions exist concerning certain aspects of the diagnosis and management in patients with degenerative conditions in the cervical spine with a history of cervical radiculopathy in a large proportion of patients referred to neurosurgical outpatient clinics.

摘要

背景

脊柱外科治疗的临床结果可能会受到患者对自身病情、治疗选择及决策过程的理解和认知的影响。本调查研究的目的是评估有神经根型颈椎病病史的颈椎退变患者对于某些信念和观点,如磁共振成像的重要性、危险因素、治疗选择及有效性。

方法

对德国和挪威两个神经外科门诊所接诊的、有神经根型颈椎病病史的颈椎退变患者这两类不同人群进行了匿名问卷调查。该调查包括七个问题:四个关于受访者的性别、年龄、既往脊柱手术史和/或针对颈椎疾病的保守治疗史的问题,以及三个关于成像在决策过程中的重要性、患者基于成像结果即使症状轻微或无症状也愿意接受颈椎手术的意愿,以及手术或保守治疗有效性的问题。

结果

211名患者回答了问卷。67%患有颈椎退变疾病的患者认为磁共振成像检查结果比临床检查结果更重要。47%的患者即使没有症状或症状轻微,也愿意基于显示异常的磁共振成像接受手术。50%的患者认为手术在治疗颈部轴性疼痛方面更有效。

结论

在转诊至神经外科门诊的大部分有神经根型颈椎病病史的颈椎退变患者中,对于诊断和治疗的某些方面存在错误观念和误解。

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