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.authorTetreault, Lindsay A.
dc.contributor.authorRhee, John
dc.contributor.authorPrather, Heidi
dc.contributor.authorKwon, Brian K.
dc.contributor.authorWilson, Jefferson R.
dc.contributor.authorMartin, Allan R.
dc.contributor.authorAndersson, Ian B.
dc.contributor.authorDembek, Anna H.
dc.contributor.authorPagarigan, Krystle T.
dc.contributor.authorDettori, Joseph R.
dc.contributor.authorFehlings, Michael G.
dc.contributor.funderCervical Spine Research Society
dc.contributor.funderAOSpine
dc.contributor.funderDeZwirek Family Foundation
dc.contributor.funderKrembil Foundation
dc.contributor.funderGerald and Tootsie Halbert Chair in Neural Repair and Regeneration
dc.date.accessioned2018-06-15T11:47:12Z
dc.date.available2018-06-15T11:47:12Z
dc.date.issued2017
dc.description.abstractStudy 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.description.statusPeer reviewed
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationTetreault, 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: 10.1177/2192568217700397en
dc.identifier.doi10.1177/2192568217700397
dc.identifier.endpage52S
dc.identifier.issn2192-5682
dc.identifier.journaltitleGlobal Spine Journalen
dc.identifier.startpage42S
dc.identifier.urihttps://hdl.handle.net/10468/6331
dc.identifier.volume7
dc.language.isoenen
dc.publisherSage Publishingen
dc.relation.urihttp://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.urihttp://www.creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectSystematic reviewen
dc.subjectNonoperative treatmenten
dc.subjectCervical spondylotic myelopathyen
dc.subjectDegenerative cervical myelopathyen
dc.titleChange in function, pain, and quality of life following structured nonoperative treatment in patients with degenerative cervical myelopathy: a systematic reviewen
dc.typeReviewen
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