Cervical Myelopathy
Conditions
Keywords
Cervical Myelopathy, Enhanced recovery after surgery, Surgical outcome
Brief summary
Enhanced recovery after surgery (ERAS) strategy has been used in the patient management of different diseases. This study aims to evaluate the effectiveness of ERAS in the perioperative period of posterior approach of cervical spine operation among patients with CSM.
Detailed description
Enhanced recovery after surgery (ERAS) strategy has been used in the patient management of different diseases, but up to now, few effort has been done to evaluate the effectiveness of ERAS in patients perioperative management of cervical spine surgery. As a interdisciplinary cooperation system, either qualitative or quantitative method alone can not completely reflect the function of ERAS. Mixed model research (MMR) is a appropriate method to evaluate a complex system, but it has not been used in ERAS evaluation. This study aims to evaluate the effectiveness of ERAS in the perioperative period of posterior approach of cervical spine operation among patients with CSM using MMR, including the retrospective quantitative part and prospective qualitative part. In the retrospective part, we will collect the data of length of stay, VAS scores, mJOA scores and SF-36 scores to compare the difference between ERAS group and regular group. In the prospective part, we will collect the data from the focus group meetings and personal interviews of patients, to verify that ERAS has the ability to improve the postoperative outcomes, while maintain an equal surgical effect.
Interventions
PROCEDUREEnhanced recovery after surgery
ERAS management includes 3 parts: (1) Preoperative analgesia and airway evaluation. (2) The protection and reconstruction of the musculo-ligamentous complex during the surgery, the safe intubation, and the local infiltration anesthesia during surgery. (3) Collar free, multimodal analgesia, airway management, and early recovery after surgery.
Sponsors
Peking University Third Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Inclusion criteria
1. Patients should be diagnosed as CSM based on the history, symptoms, Physical signs and radiographic results. 2. Patients did not respond to the 3-month conventional treatment. 3. Patients were performed posterior approach of cervical spine operation. 4. Patients should have complete pre- and post-operative data.
Exclusion criteria
1. Patients with severe organic diseases. 2. Patients with previous history of cervical spine surgery. 3. Patients with mental or psychological abnormality. 4. Patients with severe osteoporosis (T value \<-2.5).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Outcomes of pain | Preoperation | Visual analogue scale before after surgery, 0 to 10 points, higher means severer the pain is. |
| Length of stay | Admission to discharge, an average of 3 days | Length of stay |
| Neurological function | Preoperation | Modified Japanese Orthopaedic Association score before surgery, -2 to 17 points, higher means better outcome. |
| Outcomes of quality of life | Preoperation | 36-Item Short Form Survey score before surgery, 0 to 100 points, higher means better outcome. |
| Focus group meetings | Admission to discharge, an average of 3 days | Focus group meetings by specialists, to discuss the effect of ERAS and the what improvements can be made. |
| Personal interviews | At 3-month follow-up | Personal interviews of patients at 3-month follow-up |
Countries
China
Outcome results
None listed