Zhao-Rui Wang, Meng Zhang, Bang Wang, Xing-Bin Li, Ai-Bing Huang
{"title":"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。","authors":"Zhao-Rui Wang, Meng Zhang, Bang Wang, Xing-Bin Li, Ai-Bing Huang","doi":"10.1016/j.jos.2024.08.004","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To observe the effect of early cervical functional exercise (CFE) on clinical outcomes and safety of patients after anterior cervical discectomy and fusion (ACDF).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Protocol identifying number: </strong>This trial was registered in the Chinese Clinical Trial Registry (registration number: ChiCTR1900025569) on 01/09/2019.</p>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of early cervical functional exercise in patients after anterior cervical discectomy and fusion: A randomized controlled trial.\",\"authors\":\"Zhao-Rui Wang, Meng Zhang, Bang Wang, Xing-Bin Li, Ai-Bing Huang\",\"doi\":\"10.1016/j.jos.2024.08.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To observe the effect of early cervical functional exercise (CFE) on clinical outcomes and safety of patients after anterior cervical discectomy and fusion (ACDF).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Protocol identifying number: </strong>This trial was registered in the Chinese Clinical Trial Registry (registration number: ChiCTR1900025569) on 01/09/2019.</p>\",\"PeriodicalId\":16939,\"journal\":{\"name\":\"Journal of Orthopaedic Science\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-09-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Orthopaedic Science\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jos.2024.08.004\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Science","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jos.2024.08.004","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Effectiveness of early cervical functional exercise in patients after anterior cervical discectomy and fusion: A randomized controlled trial.
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.
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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