The Application of Enhanced Recovery After Surgery Clinical Pathway in Posterior Cervical Spine Surgery

Study Overview
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Brief Summary
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This study intends to establish a multidisciplinary collaborative ERAS clinical pathway of cervical posterior surgery,and to verify its effectiveness, safety and value in health economics.

Detailed Description
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Enhanced recovery after surgery (ERAS) is a new model of deep cooperation between surgery，rehabilitation medicine, anesthesiology, nursing and other disciplines in recent years, which enables patients to start rehabilitation training as soon as possible after surgery and improves the comprehensive effect of surgery. Posterior cervical surgery is traumatic, and it is significant to enhance postoperative rehabilitation to improve the overall efficacy of patients. Currently, there are no clear guidelines supporting the clinical effectiveness of ERAS in reducing complications, reducing costs, and enhancing recovery after posterior cervical surgery. Therefore, this study aims to establish a multidisciplinary ERAS model for posterior cervical surgery in Peking University Third Hospital and verify its clinical effectiveness. This is a multi-center, multidisciplinary prospective cohort study,in which the orthopedics department was combined with the anesthesiology department, rehabilitation department, nutrition department, operating room and nursing team to establish the ERAS clinical pathways for posterior cervical spine surgery. Clinical pathways include surgical procedure optimization, rehabilitation procedure optimization, anesthesia and nursing procedure optimization. As it is optimized and promoted,the ERAS clinical pathways will improve the curative effect and prognosis of posterior cervical surgery, so that more patients with cervical spondylosis will benefit.

Official Title
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The Application of Enhanced Recovery After Surgery Clinical Pathway in Posterior Cervical Spine Surgery:a Multicenter, Non-interventional Cohort Study

Conditions
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Cervical Spondylotic Myelopathy, Ossification of Posterior Longitudinal Ligament in Cervical Region

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18-70, gender unlimited; Diagnostic diagnosis of cervical spondylosis and consistent with the indications of posterior spinal canal extended laminoplasty; Basis of serious diseases of centerlessness, brain, lung, kidney or other important organs, preoperative ASA score I-II; Agree to participate in the study and sign the informed consent. Exclusion Criteria: -

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| ERAS group<br> | |
| Conventional group<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| range of motion on X - ray | range of motion the neck in extension and flexion on X - ray | preoperation | 
| range of motion on X - ray | range of motion the neck in extension and flexion on X - ray | intraoperation | 
| range of motion on X - ray | range of motion the neck in extension and flexion on X - ray | 72 hours after surgery | 
| range of motion on X - ray | range of motion the neck in extension and flexion on X - ray | 3 months after surgery | 
| range of motion on X - ray | range of motion the neck in extension and flexion on X - ray | 6 months after surgery | 
| Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire（JOACMEQ） | A questionare to evaluate the severity of cervical spondylosis myelopathy | preoperation | 
| Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire（JOACMEQ） | A questionare to evaluate the severity of cervical spondylosis myelopathy | intraoperation | 
| Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire（JOACMEQ） | A questionare to evaluate the severity of cervical spondylosis myelopathy | 72 hours after surgery | 
| Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire（JOACMEQ） | A questionare to evaluate the severity of cervical spondylosis myelopathy | 3 months after surgery | 
| Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire（JOACMEQ） | A questionare to evaluate the severity of cervical spondylosis myelopathy | 6 months after surgery | 
| multi-cervical-unit system（MCU） | To locate the cervical responsible section | preoperation | 
| multi-cervical-unit system（MCU） | To locate the cervical responsible section | intraoperation | 
| multi-cervical-unit system（MCU） | To locate the cervical responsible section | 72 hours after surgery | 
| multi-cervical-unit system（MCU） | To locate the cervical responsible section | 3 months after surgery | 
| multi-cervical-unit system（MCU） | To locate the cervical responsible section | 6 months after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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enhanced recovery after surgery, Posterior cervical surgery, posterior cervical laminoplasty, Clinical pathway