退行性颈椎脊髓病患者颈部疼痛的患病率及手术治疗后的短期反应：一项对来自全球26个地点的664例患者的队列研究
Prevalence of Neck Pain in Patients with Degenerative Cervical Myelopathy and Short-Term Response After Operative Treatment: A Cohort Study of 664 Patients From 26 Global Sites.
作者信息
Schneider Michel M, Badhiwala Jetan H, Alvi Mohammed Ali, Tetreault Lindsay A, Kalsi Pratipal, Idler Randy K, Wilson Jefferson R, Fehlings Michael G
机构信息
Division of Neurosurgery and Spine Program, Krembil Neuroscience Centre, University Health Network, Toronto, ON, Canada.
Division of Neurosurgery and Spine Program, Department of Surgery, University of Toronto, Toronto, ON, Canada.
出版信息
Global Spine J. 2024 Apr;14(3):830-838. doi: 10.1177/21925682221124098. Epub 2022 Sep 8.
STUDY DESIGN
Ambispective cohort study.
OBJECTIVES
- To define the prevalence of neck pain in patients with degenerative cervical myelopathy (DCM). 2) To identify associated factors of preoperative neck pain in patients with DCM. 3) To assess the neck pain response to surgical intervention.
METHODS
757 patients with DCM were enrolled at 26 global sites from 2005 to 2011. A total of 664 patients had complete neck pain scores preoperatively (Neck Disability Index, NDI). The prevalence and severity of neck pain preoperatively and at the 6-months follow-up was summarized. Functional assessments of individuals with and without pain were compared. Associations of preoperative neck pain and related factors were evaluated.
RESULTS
Preoperatively, 79.2% of patients reported neck pain while 20.8% had no neck pain. Of individuals with neck pain, 20.2% rated their pain as very mild, 27.9% as moderate, 19.6% as fairly severe, 9.6% as very severe and 1.9% as the worst imaginable. Functional status (mJOA), number of stenotic levels, age, and duration of symptoms did not significantly differ in patients with and without pain. Factors associated with the presence of neck pain were female gender, BMI ≥27 kg/m, rheumatologic and gastrointestinal comorbidities, and age <57 years. Neck pain improved significantly from the preoperative examination to the 6-months postoperative follow-up ( < .0001).
CONCLUSION
Here, we demonstrate a high prevalence of neck pain in patients with DCM as well as a link between gender, body weight, comorbidity and age. We highlight a significant reduction in neck pain 6 months after surgery.
研究设计
双向队列研究。
目的
1）确定退行性颈椎脊髓病（DCM）患者颈部疼痛的患病率。2）识别DCM患者术前颈部疼痛的相关因素。3）评估手术干预对颈部疼痛的反应。
方法
2005年至2011年期间，在全球26个地点招募了757例DCM患者。共有664例患者术前有完整的颈部疼痛评分（颈部功能障碍指数，NDI）。总结术前及术后6个月时颈部疼痛的患病率和严重程度。比较有疼痛和无疼痛个体的功能评估。评估术前颈部疼痛与相关因素的关联。
结果
术前，79.2%的患者报告有颈部疼痛，而20.8%的患者无颈部疼痛。在有颈部疼痛的个体中，20.2%将其疼痛评为非常轻微，27.9%为中度，19.6%为相当严重，9.6%为非常严重，1.9%为难以想象的严重。有疼痛和无疼痛的患者在功能状态（改良日本骨科学会评分，mJOA）、狭窄节段数、年龄和症状持续时间方面无显著差异。与颈部疼痛存在相关的因素为女性、体重指数（BMI）≥27kg/m²、风湿和胃肠道合并症以及年龄<57岁。从术前检查到术后6个月随访，颈部疼痛有显著改善（P<0.0001）。
结论
在此，我们证明了DCM患者颈部疼痛的高患病率以及性别、体重、合并症和年龄之间的联系。我们强调术后6个月颈部疼痛显著减轻。
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