Expert consensus on postoperative early mobility for patients undergoing anterior cervical surgery_West China Medical Journal

Authors：

 Orthopaedic Nursing Professional Committee of Chinese Nursing Association , Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Rehabilitation Medical Association , Nursing Group of Orthopaedic Professional Committee of Sichuan Medical Association

Corresponding author：

Orthopaedic Nursing Professional Committee of Chinese Nursing Association, Email: gkningning@126.com

Keywords：

Anterior cervical surgery; early mobility; expert consensus

DOI：

10.7507/1002-0179.202406247

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Getting out of bed early after surgery is an important measure to promote the clinical concept of accelerated rehabilitation surgery and promote physical and mental rehabilitation of patients. However, at present, the specific implementation plan for early postoperative ambulation of patients undergoing anterior cervical surgery has not formed a unified standard, and there is a lack of reliable evidence to recommend and guide clinical nursing practice. To this end, the Orthopaedic Nursing Professional Committee of Chinese Nursing Association, the Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Rehabilitation Medical Association, and the Nursing Group of Orthopaedic Professional Committee of Sichuan Medical Association, based on evidence-based medical evidence and combined with the clinical experience of experts in related fields, formed an expert consensus on the theme of early postoperative get-out activities of patients undergoing anterior cervical surgery. To provide reference for clinical work, 9 recommendations on early ambulation of patients undergoing anterior cervical surgery were put forward.

1.	张晓军, 胡侦明, 江维, 等. 颈椎病的手术治疗策略. 中国骨与关节杂志, 2023, 12(1): 1-3.
2.	黄定安, 汪颖峰, 詹文豪, 等. 不同颈椎前路手术治疗颈椎病对颈椎矢状面平衡参数的影响. 皖南医学院学报, 2023, 42(6): 554-556.
3.	Park D, Arveschoug A, Wahlmeier S, et al. The effect of plate thickness on fusion, complications, and outcomes in anterior cervical spine surgery. Cureus, 2023, 15(6): e41048.
4.	Robertson SC, Ashley MR. Complications of anterior cervical discectomy and fusion. Acta Neurochir Suppl, 2023, 130: 169-178.
5.	Lim S, Bazydlo M, Macki M, et al. Validation of the benefits of ambulation within 8 hours of elective cervical and lumbar surgery: a Michigan Spine Surgery Improvement Collaborative study. Neurosurgery, 2022, 91(3): 505-512.
6.	Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
7.	Higgins JP, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 2011, 343: d5928.
8.	Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
9.	OCEBM Levels of Evidence Working Group. The Oxford levels of evidence. Oxford: Oxford Centre for Evidence-Based Medicine, 1998.
10.	丁琛, 洪瑛, 王贝宇, 等. 颈椎前路手术加速康复外科实施流程专家共识. 中华骨与关节外科杂志, 2019, 12(7): 486-497.
11.	陈亚萍, 杨旭, 高娜. 脊柱围手术期临床护理实践和管理: 协和经验. 中华骨与关节外科杂志, 2021, 14(5): 355-359.
12.	Wang P, Kong C, Teng Z, et al. Enhanced recovery after surgery (ERAS) program for anterior cervical discectomy and fusion (ACDF) in patients over 60 years old. Clin Interv Aging, 2023, 18: 1619-1627.
13.	佟静, 刘宝戈, 崔维, 等. 加速康复外科理念在多节段颈椎前路手术患者围术期的应用. 中国骨与关节杂志, 2019, 8(1): 47-51.
14.	Gomes FC, Larcipretti ALL, Elvir FAR, et al. Early ambulation versus prolonged bed rest for incidental durotomies in spine procedures: a systematic review and meta-analysis. Neurosurg Rev, 2023, 46(1): 310.
15.	方业珍, 劳贤邦, 马惠, 等. Aldrete 苏醒评分在麻醉复苏期患者中的应用. 齐鲁护理杂志, 2017, 23(10): 60-62.
16.	牛建梅, 赵茜, 梁景仪, 等. 骨科患者围手术期的营养风险筛查与自主疼痛评估和跌倒风险的关系. 宁夏医学杂志, 2023, 45(6): 517-520.
17.	中华医学会肠外肠内营养学分会. 成人围手术期营养支持指南. 中华外科杂志, 2016, 54(9): 641-657.
18.	国家卫生健康委加速康复外科专家委员会骨科专家组, 中国研究型医院学会骨科加速康复专业委员会, 中国康复技术转化及促进会骨科加速康复专业委员会. 骨科大手术加速康复围手术期营养管理专家共识. 中华骨与关节外科杂志, 2022, 15(10): 763-767.
19.	王雅磊, 陈佳丽, 宁宁, 等. 基于加速康复外科理念的颈椎前路手术患者术后早期下床活动的华西方案. 华西医学, 2021, 36(10): 1419-1423.
20.	阎学梅, 何苗, 王秀丽. 术后病人直立不耐受现状及其影响因素的研究进展. 循证护理, 2022, 8(24): 3336-3338.
21.	Grubb BP. Neurocardiogenic syncope and related disorders of orthostatic intolerance. Circulation, 2005, 111(22): 2997-3006.
22.	秦芳, 李秋萍, 陈曦, 等. 外科术后患者早期下床活动评估与应对的研究进展. 护理学杂志, 2020, 35(5): 101-105.
23.	王盛, 姜文君. 徒手肌力检查发展史及分级进展. 中国康复理论与实践, 2015, 21(6): 666-669.
24.	梁丽敏, 林培芬, 欧阳婉玲. 专业康复小组联合康复训练在颈椎病术后患者中的应用. 齐鲁护理杂志, 2022, 28(8): 112-114.
25.	邓晓园, 王国蓉, 张甜, 等. 手术患者恐动症影响因素的 Meta 分析. 中国疗养医学, 2023, 32(6): 583-586.
26.	刘昊为, 黄丽, 杨宗乾, 等. 常用恐动症评估量表的研究进展. 中国康复医学杂志, 2023, 38(9): 1305-1310.
27.	Baldini G, Bagry H, Aprikian A, et al. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology, 2009, 110(5): 1139-1157.
28.	佟静, 刘宝戈, 王琳, 等. 颈椎前路术后并发脑脊液漏的早期规范离床效果: 单中心连续对照护理研究. 骨科, 2020, 11(5): 441-445.
29.	石磊, 陈德玉, 史建刚, 等. 颈椎前路手术中硬膜损伤的预防与治疗. 脊柱外科杂志, 2017, 15(3): 156-160.
30.	国家疼痛专业质控中心神经病理性疼痛专家组, 段宝霖, 樊碧发, 等. 神经病理性疼痛评估与管理中国指南(2024 版). 中国疼痛医学杂志, 2024, 30(1): 5-14.
31.	曾宪政, 宋莉. 规范化疼痛评估和管理可有效减少住院患者疼痛的发生. 中华疼痛学杂志, 2024, 20(1): 23-25.
32.	谭小翠, 高丽琴. 正念减压疗法联合多元化健康教育对脊柱骨折手术患者心理健康和疼痛的影响. 中外医学研究, 2024, 22(6): 68-72.
33.	周洁, 杨淼. 五行音乐疗法对全麻术后患者疼痛及情绪的影响. 护士进修杂志, 2017, 32(10): 872-874.
34.	Liu S, Yang DL, Zhao RY, et al. Prevalence and risk factors of axial neck pain in patients undergoing multilevel anterior cervical decompression with fusion surgery. J Orthop Surg Res, 2019, 14(1): 94-101.
35.	佟冰渡, 李高洋, 王薇, 等. 国内脊柱手术患者术后首次下床活动现状的调查研究. 中华骨与关节外科杂志, 2021, 14(7): 626-631.
36.	张子凤, 彭玉慧, 孙洁, 等. 颈椎病患者围手术期快速康复模式的探讨. 江苏医药, 2015, 41(13): 1604-1606.
37.	Mjåset C, Zwart JA, Goedmakers CMW, et al. Criteria for success after surgery for cervical radiculopathy-estimates for a substantial amount of improvement in core outcome measures. Spine J, 2020, 20(9): 1413-1421.

1. 张晓军, 胡侦明, 江维, 等. 颈椎病的手术治疗策略. 中国骨与关节杂志, 2023, 12(1): 1-3.
2. 黄定安, 汪颖峰, 詹文豪, 等. 不同颈椎前路手术治疗颈椎病对颈椎矢状面平衡参数的影响. 皖南医学院学报, 2023, 42(6): 554-556.
3. Park D, Arveschoug A, Wahlmeier S, et al. The effect of plate thickness on fusion, complications, and outcomes in anterior cervical spine surgery. Cureus, 2023, 15(6): e41048.
4. Robertson SC, Ashley MR. Complications of anterior cervical discectomy and fusion. Acta Neurochir Suppl, 2023, 130: 169-178.
5. Lim S, Bazydlo M, Macki M, et al. Validation of the benefits of ambulation within 8 hours of elective cervical and lumbar surgery: a Michigan Spine Surgery Improvement Collaborative study. Neurosurgery, 2022, 91(3): 505-512.
6. Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
7. Higgins JP, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 2011, 343: d5928.
8. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
9. OCEBM Levels of Evidence Working Group. The Oxford levels of evidence. Oxford: Oxford Centre for Evidence-Based Medicine, 1998.
10. 丁琛, 洪瑛, 王贝宇, 等. 颈椎前路手术加速康复外科实施流程专家共识. 中华骨与关节外科杂志, 2019, 12(7): 486-497.
11. 陈亚萍, 杨旭, 高娜. 脊柱围手术期临床护理实践和管理: 协和经验. 中华骨与关节外科杂志, 2021, 14(5): 355-359.
12. Wang P, Kong C, Teng Z, et al. Enhanced recovery after surgery (ERAS) program for anterior cervical discectomy and fusion (ACDF) in patients over 60 years old. Clin Interv Aging, 2023, 18: 1619-1627.
13. 佟静, 刘宝戈, 崔维, 等. 加速康复外科理念在多节段颈椎前路手术患者围术期的应用. 中国骨与关节杂志, 2019, 8(1): 47-51.
14. Gomes FC, Larcipretti ALL, Elvir FAR, et al. Early ambulation versus prolonged bed rest for incidental durotomies in spine procedures: a systematic review and meta-analysis. Neurosurg Rev, 2023, 46(1): 310.
15. 方业珍, 劳贤邦, 马惠, 等. Aldrete 苏醒评分在麻醉复苏期患者中的应用. 齐鲁护理杂志, 2017, 23(10): 60-62.
16. 牛建梅, 赵茜, 梁景仪, 等. 骨科患者围手术期的营养风险筛查与自主疼痛评估和跌倒风险的关系. 宁夏医学杂志, 2023, 45(6): 517-520.
17. 中华医学会肠外肠内营养学分会. 成人围手术期营养支持指南. 中华外科杂志, 2016, 54(9): 641-657.
18. 国家卫生健康委加速康复外科专家委员会骨科专家组, 中国研究型医院学会骨科加速康复专业委员会, 中国康复技术转化及促进会骨科加速康复专业委员会. 骨科大手术加速康复围手术期营养管理专家共识. 中华骨与关节外科杂志, 2022, 15(10): 763-767.
19. 王雅磊, 陈佳丽, 宁宁, 等. 基于加速康复外科理念的颈椎前路手术患者术后早期下床活动的华西方案. 华西医学, 2021, 36(10): 1419-1423.
20. 阎学梅, 何苗, 王秀丽. 术后病人直立不耐受现状及其影响因素的研究进展. 循证护理, 2022, 8(24): 3336-3338.
21. Grubb BP. Neurocardiogenic syncope and related disorders of orthostatic intolerance. Circulation, 2005, 111(22): 2997-3006.
22. 秦芳, 李秋萍, 陈曦, 等. 外科术后患者早期下床活动评估与应对的研究进展. 护理学杂志, 2020, 35(5): 101-105.
23. 王盛, 姜文君. 徒手肌力检查发展史及分级进展. 中国康复理论与实践, 2015, 21(6): 666-669.
24. 梁丽敏, 林培芬, 欧阳婉玲. 专业康复小组联合康复训练在颈椎病术后患者中的应用. 齐鲁护理杂志, 2022, 28(8): 112-114.
25. 邓晓园, 王国蓉, 张甜, 等. 手术患者恐动症影响因素的 Meta 分析. 中国疗养医学, 2023, 32(6): 583-586.
26. 刘昊为, 黄丽, 杨宗乾, 等. 常用恐动症评估量表的研究进展. 中国康复医学杂志, 2023, 38(9): 1305-1310.
27. Baldini G, Bagry H, Aprikian A, et al. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology, 2009, 110(5): 1139-1157.
28. 佟静, 刘宝戈, 王琳, 等. 颈椎前路术后并发脑脊液漏的早期规范离床效果: 单中心连续对照护理研究. 骨科, 2020, 11(5): 441-445.
29. 石磊, 陈德玉, 史建刚, 等. 颈椎前路手术中硬膜损伤的预防与治疗. 脊柱外科杂志, 2017, 15(3): 156-160.
30. 国家疼痛专业质控中心神经病理性疼痛专家组, 段宝霖, 樊碧发, 等. 神经病理性疼痛评估与管理中国指南(2024 版). 中国疼痛医学杂志, 2024, 30(1): 5-14.
31. 曾宪政, 宋莉. 规范化疼痛评估和管理可有效减少住院患者疼痛的发生. 中华疼痛学杂志, 2024, 20(1): 23-25.
32. 谭小翠, 高丽琴. 正念减压疗法联合多元化健康教育对脊柱骨折手术患者心理健康和疼痛的影响. 中外医学研究, 2024, 22(6): 68-72.
33. 周洁, 杨淼. 五行音乐疗法对全麻术后患者疼痛及情绪的影响. 护士进修杂志, 2017, 32(10): 872-874.
34. Liu S, Yang DL, Zhao RY, et al. Prevalence and risk factors of axial neck pain in patients undergoing multilevel anterior cervical decompression with fusion surgery. J Orthop Surg Res, 2019, 14(1): 94-101.
35. 佟冰渡, 李高洋, 王薇, 等. 国内脊柱手术患者术后首次下床活动现状的调查研究. 中华骨与关节外科杂志, 2021, 14(7): 626-631.
36. 张子凤, 彭玉慧, 孙洁, 等. 颈椎病患者围手术期快速康复模式的探讨. 江苏医药, 2015, 41(13): 1604-1606.
37. Mjåset C, Zwart JA, Goedmakers CMW, et al. Criteria for success after surgery for cervical radiculopathy-estimates for a substantial amount of improvement in core outcome measures. Spine J, 2020, 20(9): 1413-1421.

West China Medical Journal

Latest ArticlesExpert consensus on postoperative early mobility for patients undergoing anterior cervical surgery

Abstract Full text Figures/Tables Video References Cited by

Format

Content