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.
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.
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.
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%).
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.
PROSPERO (CRD42024604184).
系统文献综述与患者信息范围界定综述
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。
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。
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。
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。
PROSPERO（CRD42024604184）
