Bharat Ratna Dr. Babasaheb Ambedkar Memorial Hospital.
Chaitanya Spine Clinic.
Spine (Phila Pa 1976). 2023 Mar 1;48(5):295-300. doi: 10.1097/BRS.0000000000004542. Epub 2022 Nov 15.
Prospective randomized control trial.
To analyze outcomes following the injection of cerebrolysin in surgically treated patients with degenerative cervical myelopathy (DCM).
Previous research has concluded that superior functional outcomes are achieved with the use of cerebrolysin in surgically treated patients of DCM for 21 days. Our study has been conducted to analyze the use of this drug for a shorter duration (10 days) and compare its clinical efficacy.
Ninety operated cases of mild to severe DCM were randomized into two groups. Sixty patients received the injection Cerebrolysin for 10 days postoperatively. The remaining 30 patients received a placebo. Functional outcomes were measured using modified Japanese Orthopaedic Association (mJOA) scores and visual analogue scale (VAS). The American Spinal Injury Association (ASIA) scale was used to document neurological recovery. Hand function was assessed by measuring the grip strength and the upper limb function score the upper extremity motor mJOA plus upper extremity sensory mJOA score. Assessments were performed and preoperatively and postoperatively and at one-month, three-month, six-month, and one-year following surgery.
Preoperative mJOA and VAS scores were comparable in both groups ( P >0.05). Both groups experienced an improvement in mJOA and VAS scores at all time-points during follow-up as compared with preoperative scores. However, the cerebrolysin group demonstrated significantly greater mJOA scores (16.37±1) when compared with the placebo (15.2±1.8) at one-year follow-up ( P <0.0001). Neurological improvement with cerebrolysin therapy was also superior ( P =0.04). No significant adverse reactions were documented.
Injection cerebrolysin, when administered for 10 days postoperatively, can result in significantly greater neurological improvement and hand function in patients with DCM who also receive surgery.
前瞻性随机对照试验。
分析脑活素治疗退行性颈椎脊髓病（DCM）手术患者的疗效。
先前的研究得出结论，在接受 DCM 手术治疗的患者中，使用脑活素治疗 21 天可获得更好的功能结果。我们的研究旨在分析使用这种药物较短时间（10 天）的效果，并比较其临床疗效。
90 例轻至重度 DCM 手术患者随机分为两组。60 例患者术后接受脑活素注射治疗 10 天。其余 30 例患者接受安慰剂。使用改良日本矫形协会（mJOA）评分和视觉模拟量表（VAS）测量功能结果。美国脊髓损伤协会（ASIA）量表用于记录神经恢复情况。手部功能通过测量握力和上肢功能评分上肢运动 mJOA 加上肢感觉 mJOA 评分来评估。评估在术前和术后以及术后 1 个月、3 个月、6 个月和 1 年进行。
两组患者术前 mJOA 和 VAS 评分无差异（P>0.05）。两组患者在随访期间的所有时间点 mJOA 和 VAS 评分均较术前有所改善。然而，与安慰剂组（15.2±1.8）相比，脑活素组在 1 年随访时的 mJOA 评分（16.37±1）显著更高（P<0.0001）。脑活素治疗的神经改善也更优（P=0.04）。未记录到明显的不良反应。
在接受手术治疗的 DCM 患者中，术后 10 天内注射脑活素可显著改善神经功能和手部功能。
