Change in function, pain, and quality of life following structured nonoperative treatment in patients with degenerative cervical myelopathy: a systematic review

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dc.contributor.author Tetreault, Lindsay A.
dc.contributor.author Rhee, John
dc.contributor.author Prather, Heidi
dc.contributor.author Kwon, Brian K.
dc.contributor.author Wilson, Jefferson R.
dc.contributor.author Martin, Allan R.
dc.contributor.author Andersson, Ian B.
dc.contributor.author Dembek, Anna H.
dc.contributor.author Pagarigan, Krystle T.
dc.contributor.author Dettori, Joseph R.
dc.contributor.author Fehlings, Michael G.
dc.date.accessioned 2018-06-15T11:47:12Z
dc.date.available 2018-06-15T11:47:12Z
dc.date.issued 2017
dc.identifier.citation Tetreault, L. A., Rhee, J., Prather, H., Kwon, B. K., Wilson, J. R., Martin, A. R., Andersson, I. B., Dembek, A. H., Pagarigan, K. T., Dettori, J. R. and Fehlings, M. G. (2017) 'Change in function, pain, and quality of life following structured nonoperative treatment in patients with degenerative cervical myelopathy: a systematic review', Global Spine Journal, 7(3S), pp. 42S-52S. doi: 10.1177/2192568217700397 en
dc.identifier.volume 7
dc.identifier.startpage 42S
dc.identifier.endpage 52S
dc.identifier.issn 2192-5682
dc.identifier.uri http://hdl.handle.net/10468/6331
dc.identifier.doi 10.1177/2192568217700397
dc.description.abstract Study Design: Systematic review. Objectives: The objective of this study was to conduct a systematic review to determine (1) change in function, pain, and quality of life following structured nonoperative treatment for degenerative cervical myelopathy (DCM); (2) variability of change in function, pain, and quality of life following different types of structured nonoperative treatment; (3) differences in outcomes observed between certain subgroups (eg, baseline severity score, duration of symptoms); and (4) negative outcomes and harms resulting from structured nonoperative treatment. Methods: A systematic search was conducted in Embase, PubMed, and the Cochrane Collaboration for articles published between January 1, 1950, and February 9, 2015. Studies were included if they evaluated outcomes following structured nonoperative treatment, including therapeutic exercise, manual therapy, cervical bracing, and/or traction. The quality of each study was evaluated using the Newcastle-Ottawa Scale, and strength of the overall body of evidence was rated using guidelines outlined by the Grading of Recommendation Assessment, Development and Evaluation Working Group. Results: Of the 570 retrieved citations, 8 met inclusion criteria and were summarized in this review. Based on our results, there is very low evidence to suggest that structured nonoperative treatment for DCM results in either a positive or negative change in function as evaluated by the Japanese Orthopaedic Association score. Conclusion: There is a lack of evidence to determine the role of nonoperative treatment in patients with DCM. However, in the majority of studies, patients did not achieve clinically significant gains in function following structured nonoperative treatment. Furthermore, 23% to 54% of patients managed nonoperatively subsequently underwent surgical treatment. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Sage Publishing en
dc.relation.uri http://journals.sagepub.com/doi/full/10.1177/2192568217700397
dc.rights © 2017, the Authors. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). en
dc.rights.uri http://www.creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject Systematic review en
dc.subject Nonoperative treatment en
dc.subject Cervical spondylotic myelopathy en
dc.subject Degenerative cervical myelopathy en
dc.title Change in function, pain, and quality of life following structured nonoperative treatment in patients with degenerative cervical myelopathy: a systematic review en
dc.type Review en
dc.internal.authorcontactother Lindsay A. Tetreault, Medicine, University College Cork, Cork, Ireland. +353-21-490-3000 Email: 116100017@umail.ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Cervical Spine Research Society
dc.contributor.funder AOSpine
dc.contributor.funder DeZwirek Family Foundation
dc.contributor.funder Krembil Foundation
dc.contributor.funder Gerald and Tootsie Halbert Chair in Neural Repair and Regeneration
dc.description.status Peer reviewed
dc.identifier.journaltitle Global Spine Journal en
dc.internal.IRISemailaddress 116100017@umail.ucc.ie en


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© 2017,  the Authors. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Except where otherwise noted, this item's license is described as © 2017, the Authors. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
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