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：

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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.

Citation： 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. Expert consensus on postoperative early mobility for patients undergoing anterior cervical surgery. West China Medical Journal, 2024, 39(10): 1514-1519. doi: 10.7507/1002-0179.202406247 Copy

1.	張曉軍, 胡偵明, 江維, 等. 頸椎病的手術治療策略. 中國骨與關節雜志, 2023, 12(1): 1-3.
2.	黃定安, 汪穎峰, 詹文豪, 等. 不同頸椎前路手術治療頸椎病對頸椎矢狀面平衡參數的影響. 皖南醫學院學報, 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, G?tzsche 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, 王貝宇, 等. 頸椎前路手術加速康復外科實施流程專家共識. 中華骨與關節外科雜志, 2019, 12(7): 486-497.
11.	陳亞萍, 楊旭, 高娜. 脊柱圍手術期臨床護理實踐和管理: 協和經驗. 中華骨與關節外科雜志, 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.	佟靜, 劉寶戈, 崔維, 等. 加速康復外科理念在多節段頸椎前路手術患者圍術期的應用. 中國骨與關節雜志, 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.	方業珍, 勞賢邦, 馬惠, 等. Aldrete 蘇醒評分在麻醉復蘇期患者中的應用. 齊魯護理雜志, 2017, 23(10): 60-62.
16.	牛建梅, 趙茜, 梁景儀, 等. 骨科患者圍手術期的營養風險篩查與自主疼痛評估和跌倒風險的關系. 寧夏醫學雜志, 2023, 45(6): 517-520.
17.	中華醫學會腸外腸內營養學分會. 成人圍手術期營養支持指南. 中華外科雜志, 2016, 54(9): 641-657.
18.	國家衛生健康委加速康復外科專家委員會骨科專家組, 中國研究型醫院學會骨科加速康復專業委員會, 中國康復技術轉化及促進會骨科加速康復專業委員會. 骨科大手術加速康復圍手術期營養管理專家共識. 中華骨與關節外科雜志, 2022, 15(10): 763-767.
19.	王雅磊, 陳佳麗, 寧寧, 等. 基于加速康復外科理念的頸椎前路手術患者術后早期下床活動的華西方案. 華西醫學, 2021, 36(10): 1419-1423.
20.	閻學梅, 何苗, 王秀麗. 術后病人直立不耐受現狀及其影響因素的研究進展. 循證護理, 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, 陳曦, 等. 外科術后患者早期下床活動評估與應對的研究進展. 護理學雜志, 2020, 35(5): 101-105.
23.	王盛, 姜文君. 徒手肌力檢查發展史及分級進展. 中國康復理論與實踐, 2015, 21(6): 666-669.
24.	梁麗敏, 林培芬, 歐陽婉玲. 專業康復小組聯合康復訓練在頸椎病術后患者中的應用. 齊魯護理雜志, 2022, 28(8): 112-114.
25.	鄧曉園, 王國蓉, 張甜, 等. 手術患者恐動癥影響因素的 Meta 分析. 中國療養醫學, 2023, 32(6): 583-586.
26.	劉昊為, 黃麗, 楊宗乾, 等. 常用恐動癥評估量表的研究進展. 中國康復醫學雜志, 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.	佟靜, 劉寶戈, 王琳, 等. 頸椎前路術后并發腦脊液漏的早期規范離床效果: 單中心連續對照護理研究. 骨科, 2020, 11(5): 441-445.
29.	石磊, 陳德玉, 史建剛, 等. 頸椎前路手術中硬膜損傷的預防與治療. 脊柱外科雜志, 2017, 15(3): 156-160.
30.	國家疼痛專業質控中心神經病理性疼痛專家組, 段寶霖, 樊碧發, 等. 神經病理性疼痛評估與管理中國指南(2024 版). 中國疼痛醫學雜志, 2024, 30(1): 5-14.
31.	曾憲政, 宋莉. 規范化疼痛評估和管理可有效減少住院患者疼痛的發生. 中華疼痛學雜志, 2024, 20(1): 23-25.
32.	譚小翠, 高麗琴. 正念減壓療法聯合多元化健康教育對脊柱骨折手術患者心理健康和疼痛的影響. 中外醫學研究, 2024, 22(6): 68-72.
33.	周潔, 楊淼. 五行音樂療法對全麻術后患者疼痛及情緒的影響. 護士進修雜志, 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. 國內脊柱手術患者術后首次下床活動現狀的調查研究. 中華骨與關節外科雜志, 2021, 14(7): 626-631.
36.	張子鳳, 彭玉慧, 孫潔, 等. 頸椎病患者圍手術期快速康復模式的探討. 江蘇醫藥, 2015, 41(13): 1604-1606.
37.	Mj?set 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. 張曉軍, 胡偵明, 江維, 等. 頸椎病的手術治療策略. 中國骨與關節雜志, 2023, 12(1): 1-3.
2. 黃定安, 汪穎峰, 詹文豪, 等. 不同頸椎前路手術治療頸椎病對頸椎矢狀面平衡參數的影響. 皖南醫學院學報, 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, G?tzsche 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, 王貝宇, 等. 頸椎前路手術加速康復外科實施流程專家共識. 中華骨與關節外科雜志, 2019, 12(7): 486-497.
11. 陳亞萍, 楊旭, 高娜. 脊柱圍手術期臨床護理實踐和管理: 協和經驗. 中華骨與關節外科雜志, 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. 佟靜, 劉寶戈, 崔維, 等. 加速康復外科理念在多節段頸椎前路手術患者圍術期的應用. 中國骨與關節雜志, 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. 方業珍, 勞賢邦, 馬惠, 等. Aldrete 蘇醒評分在麻醉復蘇期患者中的應用. 齊魯護理雜志, 2017, 23(10): 60-62.
16. 牛建梅, 趙茜, 梁景儀, 等. 骨科患者圍手術期的營養風險篩查與自主疼痛評估和跌倒風險的關系. 寧夏醫學雜志, 2023, 45(6): 517-520.
17. 中華醫學會腸外腸內營養學分會. 成人圍手術期營養支持指南. 中華外科雜志, 2016, 54(9): 641-657.
18. 國家衛生健康委加速康復外科專家委員會骨科專家組, 中國研究型醫院學會骨科加速康復專業委員會, 中國康復技術轉化及促進會骨科加速康復專業委員會. 骨科大手術加速康復圍手術期營養管理專家共識. 中華骨與關節外科雜志, 2022, 15(10): 763-767.
19. 王雅磊, 陳佳麗, 寧寧, 等. 基于加速康復外科理念的頸椎前路手術患者術后早期下床活動的華西方案. 華西醫學, 2021, 36(10): 1419-1423.
20. 閻學梅, 何苗, 王秀麗. 術后病人直立不耐受現狀及其影響因素的研究進展. 循證護理, 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, 陳曦, 等. 外科術后患者早期下床活動評估與應對的研究進展. 護理學雜志, 2020, 35(5): 101-105.
23. 王盛, 姜文君. 徒手肌力檢查發展史及分級進展. 中國康復理論與實踐, 2015, 21(6): 666-669.
24. 梁麗敏, 林培芬, 歐陽婉玲. 專業康復小組聯合康復訓練在頸椎病術后患者中的應用. 齊魯護理雜志, 2022, 28(8): 112-114.
25. 鄧曉園, 王國蓉, 張甜, 等. 手術患者恐動癥影響因素的 Meta 分析. 中國療養醫學, 2023, 32(6): 583-586.
26. 劉昊為, 黃麗, 楊宗乾, 等. 常用恐動癥評估量表的研究進展. 中國康復醫學雜志, 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. 佟靜, 劉寶戈, 王琳, 等. 頸椎前路術后并發腦脊液漏的早期規范離床效果: 單中心連續對照護理研究. 骨科, 2020, 11(5): 441-445.
29. 石磊, 陳德玉, 史建剛, 等. 頸椎前路手術中硬膜損傷的預防與治療. 脊柱外科雜志, 2017, 15(3): 156-160.
30. 國家疼痛專業質控中心神經病理性疼痛專家組, 段寶霖, 樊碧發, 等. 神經病理性疼痛評估與管理中國指南(2024 版). 中國疼痛醫學雜志, 2024, 30(1): 5-14.
31. 曾憲政, 宋莉. 規范化疼痛評估和管理可有效減少住院患者疼痛的發生. 中華疼痛學雜志, 2024, 20(1): 23-25.
32. 譚小翠, 高麗琴. 正念減壓療法聯合多元化健康教育對脊柱骨折手術患者心理健康和疼痛的影響. 中外醫學研究, 2024, 22(6): 68-72.
33. 周潔, 楊淼. 五行音樂療法對全麻術后患者疼痛及情緒的影響. 護士進修雜志, 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. 國內脊柱手術患者術后首次下床活動現狀的調查研究. 中華骨與關節外科雜志, 2021, 14(7): 626-631.
36. 張子鳳, 彭玉慧, 孫潔, 等. 頸椎病患者圍手術期快速康復模式的探討. 江蘇醫藥, 2015, 41(13): 1604-1606.
37. Mj?set 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.

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Expert consensus on postoperative early mobility for patients undergoing anterior cervical surgery

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