Department of Orthopedic Surgery, Örebro University School of Medical Sciences, Örebro University Hospital, Örebro, Sweden.
Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden.
Trials. 2021 Sep 8;22(1):607. doi: 10.1186/s13063-021-05492-2.
Cervical radiculopathy is the most common disease in the cervical spine, affecting patients around 50-55 year of age. An operative treatment is common clinical praxis when non-operative treatment fails. The controversy is in the choice of operative treatment, conducting either anterior cervical decompression and fusion or posterior foraminotomy. The study objective is to evaluate short- and long-term outcome of anterior cervical decompression and fusion (ACDF) and posterior foraminotomy (PF) METHODS: A multicenter prospective randomized controlled trial with 1:1 randomization, ACDF vs. PF including 110 patients. The primary aim is to evaluate if PF is non-inferior to ACDF using a non-inferiority design with ACDF as "active control." The neck disability index (NDI) is the primary outcome measure, and duration of follow-up is 2 years.
Due to absence of high level of evidence, the authors believe that a RCT will improve the evidence for using the different surgical treatments for cervical radiculopathy and strengthen current surgical treatment recommendation.
ClinicalTrials.gov NCT04177849. Registered on November 26, 2019.
神经根型颈椎病是颈椎最常见的疾病,影响 50-55 岁左右的患者。当非手术治疗失败时,手术治疗是常见的临床实践。争议在于手术治疗的选择,是进行前路颈椎减压融合术(ACDF)还是后路椎间孔切开术(PF)。本研究的目的是评估前路颈椎减压融合术(ACDF)和后路椎间孔切开术(PF)的短期和长期疗效。
这是一项多中心前瞻性随机对照临床试验,采用 1:1 随机分组,将 ACDF 与 PF 进行比较,共纳入 110 例患者。主要目的是采用非劣效性设计,以 ACDF 为“主动对照”,评估 PF 是否不劣于 ACDF。颈椎残障指数(NDI)是主要的观察指标,随访时间为 2 年。
由于缺乏高级别的证据,作者认为 RCT 将提高使用不同手术治疗神经根型颈椎病的证据水平,并加强当前的手术治疗建议。
ClinicalTrials.gov NCT04177849. 注册于 2019 年 11 月 26 日。