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本文引用的文献

1
ISSLS prize in clinical science 2020: the reliability and interpretability of score change in lumbar spine research.2020 年国际脊柱侧凸研究学会临床科学奖:腰椎研究中评分变化的可靠性和可解释性。
Eur Spine J. 2020 Apr;29(4):663-669. doi: 10.1007/s00586-019-06222-8. Epub 2019 Nov 23.
2
Posterior foraminotomy versus anterior decompression and fusion in patients with cervical degenerative disc disease with radiculopathy: up to 5 years of outcome from the national Swedish Spine Register.后路椎间孔切开术与前路减压融合术治疗神经根型颈椎病性椎间盘疾病患者的疗效比较:来自瑞典国家脊柱注册中心的长达5年的随访结果
J Neurosurg Spine. 2019 Nov 15;32(3):344-352. doi: 10.3171/2019.9.SPINE19787. Print 2020 Mar 1.
3
Minimally Invasive Posterior Cervical Foraminotomy as an Alternative to Anterior Cervical Discectomy and Fusion for Unilateral Cervical Radiculopathy: A Systematic Review and Meta-analysis.微创后路颈椎侧方减压术作为单侧颈椎病神经根病的替代方案:一项系统评价和荟萃分析。
Spine (Phila Pa 1976). 2019 Dec 15;44(24):1731-1739. doi: 10.1097/BRS.0000000000003156.
4
Comparison of Anterior Cervical Foraminotomy and Posterior Cervical Foraminotomy for Treating Single Level Unilateral Cervical Radiculopathy.颈椎前路椎间孔切开术与颈椎后路椎间孔切开术治疗单节段单侧神经根型颈椎病的比较。
Spine (Phila Pa 1976). 2019 Oct 1;44(19):1339-1347. doi: 10.1097/BRS.0000000000003081.
5
Artificial disc replacement versus fusion in patients with cervical degenerative disc disease and radiculopathy: a randomized controlled trial with 5-year outcomes.人工椎间盘置换与融合治疗颈椎退行性椎间盘疾病伴根性病变患者的随机对照试验:5 年随访结果
J Neurosurg Spine. 2019 Jan 11;30(3):323-331. doi: 10.3171/2018.9.SPINE18659. Print 2019 Mar 1.
6
Minimally invasive posterior cervical foraminotomy with tubes to prevent undesired fusion: a long-term follow-up study.采用管道进行微创后路颈椎椎间孔切开术以防止不必要的融合:一项长期随访研究
J Neurosurg Spine. 2018 Oct;29(4):358-364. doi: 10.3171/2018.2.SPINE171003. Epub 2018 Jun 29.
7
CONSORT Statement for Randomized Trials of Nonpharmacologic Treatments: A 2017 Update and a CONSORT Extension for Nonpharmacologic Trial Abstracts.CONSORT 声明:非药物治疗随机试验的更新和非药物试验摘要的 CONSORT 扩展(2017 年)。
Ann Intern Med. 2017 Jul 4;167(1):40-47. doi: 10.7326/M17-0046. Epub 2017 Jun 20.
8
The physics of MRI safety.磁共振成像安全物理学
J Magn Reson Imaging. 2018 Jan;47(1):28-43. doi: 10.1002/jmri.25761. Epub 2017 May 19.
9
Iatrogenic Spinal Cord Injury Resulting From Cervical Spine Surgery.颈椎手术导致的医源性脊髓损伤
Global Spine J. 2017 Apr;7(1 Suppl):84S-90S. doi: 10.1177/2192568216688188. Epub 2017 Apr 1.
10
A Multicenter Review of Superior Laryngeal Nerve Injury Following Anterior Cervical Spine Surgery.颈椎前路手术后喉上神经损伤的多中心回顾
Global Spine J. 2017 Apr;7(1 Suppl):7S-11S. doi: 10.1177/2192568216687296. Epub 2017 Apr 1.

颈椎神经根病的手术治疗:前路颈椎减压融合术与后路椎间孔切开术的比较:一项随机对照试验的研究方案。

Operative treatment of cervical radiculopathy: anterior cervical decompression and fusion compared with posterior foraminotomy: study protocol for a randomized controlled trial.

机构信息

Department of Orthopedic Surgery, Örebro University School of Medical Sciences, Örebro University Hospital, Örebro, Sweden.

Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden.

出版信息

Trials. 2021 Sep 8;22(1):607. doi: 10.1186/s13063-021-05492-2.

DOI:10.1186/s13063-021-05492-2
PMID:34496941
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8425018/
Abstract

BACKGROUND

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.

DISCUSSION

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.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04177849. Registered on November 26, 2019.

摘要

背景

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。

方法

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。

讨论

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。

试验注册

ClinicalTrials.gov NCT04177849. 注册于 2019 年 11 月 26 日。