Effectiveness of early cervical functional exercise in patients after anterior cervical discectomy and fusion: A randomized controlled trial.

IF 1.5 4区 医学 Q3 ORTHOPEDICS
Zhao-Rui Wang, Meng Zhang, Bang Wang, Xing-Bin Li, Ai-Bing Huang
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引用次数: 0

Abstract

Objective: To observe the effect of early cervical functional exercise (CFE) on clinical outcomes and safety of patients after anterior cervical discectomy and fusion (ACDF).

Methods: Sixty patients who underwent ACDF from September 2019 to September 2020 were analyzed and randomly divided into two groups: the CFE group (27 cases) and the usual care (UC) group (33 cases). Then, all patients in the two groups received routine postoperative guidance care at the same time. Besides, the patients of the CFE group underwent a cervical functional exercise program after on the third day after ACDF. The evaluation was conducted preoperatively and at 1 week, 1 month and 6 months after surgery. The Visual Analogue Scale (VAS), Neck Disability Index (NDI) and Japanese Orthopaedic Association scores (JOA) were used to assess clinical outcomes and the safety was confirmed with routine postoperative radiological visits to ensure intervertebral stability.

Results: The CFE group reported lower neck pain scores on VAS at 1 month after surgery (P = 0.02) and higher postoperative scores by JOA at 1 month and 6 months, neck disability on NDI at 1 week, 1 month and 6 months after surgery (P < 0.05) compared to the UC group. For postoperative dysfunction, the CFE group had more significant changes than the UC group at 1 month and 6 months after surgery (P < 0.05). There was no statistical difference in cervical curves, fusion rate and fusion status between the two groups, and no revision surgery was recorded although a patient has one screw partially back out in UC group.

Conclusion: Our study suggested that the cervical functional exercise could decrease cervical pain and improve postoperative function in patients after ACDF. It was a safe and effective treatment for postoperative rehabilitation. The use of a postoperative collar, especially for one or two-level ACDF may not be needed.

Protocol identifying number: This trial was registered in the Chinese Clinical Trial Registry (registration number: ChiCTR1900025569) on 01/09/2019.

颈椎前路椎间盘切除和融合术后患者早期颈椎功能锻炼的效果:随机对照试验。
目的观察早期颈椎功能锻炼(CFE)对颈椎前路椎间盘切除融合术(ACDF)后患者临床疗效及安全性的影响:分析2019年9月至2020年9月期间接受ACDF的60例患者,并将其随机分为两组:CFE组(27例)和常规护理(UC)组(33例)。然后,两组所有患者同时接受术后常规指导护理。此外,CFE 组患者在 ACDF 术后第三天开始进行颈椎功能锻炼。评估在术前、术后一周、一个月和六个月进行。采用视觉模拟量表(VAS)、颈部残疾指数(NDI)和日本骨科协会(JOA)评分来评估临床效果,并通过术后常规放射学检查来确保椎体间的稳定性:结果:CFE 组术后 1 个月的 VAS 颈部疼痛评分较低(P = 0.02),术后 1 个月和 6 个月的 JOA 评分较高,术后 1 周、1 个月和 6 个月的 NDI 颈部残疾评分较高(P 结论:CFE 术后 1 个月的 VAS 颈部疼痛评分较低(P = 0.02),术后 1 个月和 6 个月的 JOA 评分较高:我们的研究表明,颈椎功能锻炼可减轻 ACDF 术后患者的颈椎疼痛并改善其术后功能。这是一种安全有效的术后康复治疗方法。术后可能不需要使用颈圈,尤其是对于一、二级 ACDF:本试验于2019年9月1日在中国临床试验注册中心注册(注册号:ChiCTR1900025569)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Orthopaedic Science
Journal of Orthopaedic Science 医学-整形外科
CiteScore
3.00
自引率
0.00%
发文量
290
审稿时长
90 days
期刊介绍: The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.
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