Khosravi Sepehr, Farahbakhsh Farzin, Hesari Marjan, Shahmohammadi Alireza, Aliakbargolkar Alireza, Baigi Vali, Eskandari Zahra, Ghodsi Zahra, Harrop James, Rahimi-Movaghar Vafa, Ghodsi Seyed Mohammad
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Global Spine J. 2024 Mar;14(2):697-706. doi: 10.1177/21925682231164346. Epub 2023 Mar 13.
Systematic Reviews.
To investigate predictors of surgical outcomes for mild Degenerative Cervical Myelopathy (DCM) by reviewing all related studies conducted at this point.
An electronic search was carried out in PubMed, EMBASE, Scopus, and Web of Science until June 23, 2021. Full-text articles reporting surgical outcome predictors of mild DCM cases were eligible. We included studies with mild DCM which was defined as a modified Japanese Orthopaedic Association score of 15 to 17 or a Japanese Orthopaedic Association score of 13 to 16. Independent reviewers screened all the records, and discrepancies between the reviewers were solved in a session with the senior author. For risk of bias assessment, RoB 2 tool was used for randomized clinical trials and ROBINS-I for non-randomized studies.
After screening 6 087 manuscripts, only 8 studies met the inclusion criteria. Lower pre-operative mJOA scores and quality-of-life measurement scores were reported by multiple studies to predict better surgical outcomes compared to other groups. High-intensity pre-operative T2 magnetic resonance imaging (MRI) was also reported to predict poor outcomes. Neck pain before intervention resulted in improved patient-reported outcomes. Two studies also reported motor symptoms prior to surgery as outcome predictors.
Lower quality of life before surgery, neck pain, lower pre-operative mJOA scores, motor symptoms before surgery, female gender, gastrointestinal comorbidities, surgical procedure and surgeon's experience with specific techniques, and high signal intensity of cord in T2 MRI were the surgical outcome predictors reported in the literature. Lower Quality of Life (QoL) score and neck prior to surgery were reported as predictors of the more improved outcome, but high cord signal intensity in T2 MRI was reported as an unfavorable outcome predictor.
系统评价。
通过回顾目前所有相关研究，调查轻度退行性颈椎病（DCM）手术结果的预测因素。
截至2021年6月23日，在PubMed、EMBASE、Scopus和Web of Science上进行了电子检索。报告轻度DCM病例手术结果预测因素的全文文章符合要求。我们纳入了轻度DCM的研究，轻度DCM定义为改良日本骨科学会评分为15至17分或日本骨科学会评分为13至16分。独立 reviewers 筛选了所有记录，reviewers 之间的差异在与资深作者的会议中得到解决。对于偏倚风险评估，随机临床试验使用RoB 2工具，非随机研究使用ROBINS-I。
在筛选了6087篇手稿后，只有8项研究符合纳入标准。多项研究报告称，与其他组相比，术前较低的改良日本骨科学会（mJOA）评分和生活质量测量评分可预测更好的手术结果。术前高强度T2磁共振成像（MRI）也被报告可预测不良结果。干预前的颈部疼痛导致患者报告的结果有所改善。两项研究还报告了术前运动症状作为结果预测因素。
术前生活质量较低、颈部疼痛、术前mJOA评分较低、术前运动症状、女性性别、胃肠道合并症、手术操作和外科医生的特定技术经验，以及T2 MRI中脊髓的高信号强度是文献中报道的手术结果预测因素。术前较低的生活质量（QoL）评分和颈部被报告为结果改善更多的预测因素，但T2 MRI中脊髓的高信号强度被报告为不良结果预测因素。
