Smith Toby O, Newton Christopher, Farrell Ayshea, Boby Jithy, Dove Jonathan, Dove Fiona, Turner Kelly, Davies Benjamin M
Warwick Medical School, University of Warwick, Coventry, UK.
Institute for Applied & Translational Technologies in Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Spinal Cord. 2025 Jul 23. doi: 10.1038/s41393-025-01110-z.
STUDY DESIGN: Systematic Literature Review & Patient-Information Scoping Review OBJECTIVES: To assess the evidence on prehabilitation and post-operative rehabilitation interventions for people undergoing surgery for degenerative cervical myelopathy (DCM) and to determine what publicly accessible information is provided to patients from the NHS surrounding DCM surgery. METHODS: A systematic literature review was searched from inception to 19 May 2025. Studies reporting pain, function, disability or quality of life for prehabilitation or post-operative rehabilitation interventions for people undergoing DCM surgery were eligible. Downs and Black appraisal tool was used to assess study quality. Data were analysed in a narrative analysis. Secondary, a review of UK NHS Patient Information Documents (PID) was searched using a Google platform assessment. PID reporting prehabilitation or post-operative information for people awaiting DCM surgery were included. The type of information being provided were extracted and descriptive statistics were used to report frequency of information provision. RESULTS: From 5218 screened studies, six studies (n = 685) met the eligibility criteria. The evidence was low to moderate in quality. Rehabilitation offered demonstrated improved clinical outcomes but there was limited evidence compared to non-rehabilitation or superiority between different rehabilitation strategies. The PID review identified 38 documents. This indicates education and guidance is commonly offered on returning to work (68%), driving (76%) and normal activities of daily living (63%). CONCLUSION: There remains uncertainty on what should be and is offered to patients with DCM in respect to prehabilitation or post-operative rehabilitation. Robust clinical trial evidence on rehabilitation approaches for this population is needed. REGISTRATION: PROSPERO (CRD42024604184).
研究设计:系统文献综述与患者信息范围界定综述 目的:评估关于退行性颈椎病(DCM)手术患者术前康复和术后康复干预的证据,并确定英国国家医疗服务体系(NHS)向DCM手术患者提供了哪些可公开获取的信息。 方法:从研究起始至2025年5月19日进行系统文献综述。纳入报告DCM手术患者术前康复或术后康复干预的疼痛、功能、残疾或生活质量的研究。使用唐斯和布莱克评估工具评估研究质量。采用叙述性分析方法对数据进行分析。其次,使用谷歌平台评估对英国NHS患者信息文件(PID)进行检索。纳入报告等待DCM手术患者术前或术后信息的PID。提取所提供信息的类型,并使用描述性统计报告信息提供的频率。 结果:在5218项筛选研究中,六项研究(n = 685)符合纳入标准。证据质量低至中等。所提供的康复措施显示出临床结局有所改善,但与非康复措施相比证据有限,且不同康复策略之间的优越性证据不足。PID综述确定了38份文件。这表明通常会提供关于重返工作(68%)、驾驶(76%)和日常生活正常活动(63%)的教育和指导。 结论:关于DCM患者术前或术后康复应提供什么以及实际提供了什么,仍存在不确定性。需要针对该人群康复方法的有力临床试验证据。 注册信息:PROSPERO(CRD42024604184)
Spine (Phila Pa 1976). 2013-10-15
Cochrane Database Syst Rev. 2012-9-12
Cochrane Database Syst Rev. 2017-6-28
Cochrane Database Syst Rev. 2017-12-8
Cochrane Database Syst Rev. 2014-4-29
Cochrane Database Syst Rev. 2018-9-19
Spine (Phila Pa 1976). 2023-10-1