BACKGROUND: It was necessary to summarize and evaluate many conservative treatments for cervical myelopathy, while no a classical therapy was widely accepted nowadays. OBJECTIVE: To evaluate the effect and safety of conservative treatment for treating cervical myelopathy by Cochrane evaluation systems. DESIGN, TIME AND SETTING: Randomized controlled trial and quasi-randomized controlled trial were performed at the Chinese Evidence-Based Medical Center of West China Hospital of Sichuan University from March to June 2008. PARTICIPANTS: 542 patients, aged from 30 to 71 years, were randomly selected from 4 papers in the CCBM, CNKI and VIP databases and related partial documents searched by hands from January 1978 to April 2008. METHODS: Most data were searched from CCBM, CNKI and VIP databases by computer. Telephone interview with original authors were used to identify reality of randomized controlled trial; random control trial was adopted in course of conservative treatment for cervical myelopathy and its quality was assessed. Those date could not be analyzed together for lack of the same intervention method, so single MeTa analysis was used. Some evaluations such as random method-selection bias, allocation concealment-selection bias, blind method-performance bias and measurement bias, exclusion, lose to follow-up, withdraw-attrition bias were chosen. MAIN OUTCOME MEASURES: (1) Curative effects between acupuncture, electroacupuncture, cupping and chlorzoxazone, nifedipine, citicoline; (2) Curative effects between acupuncture, massage, traditional Chinese medicine and diclofenac; (3) Curative effects between selective angle traction and traction of zero angle; (4) Curative effects between traditional Chinese medicine and mikebao; (5) Adverse reaction. RESULTS: Studies fitted with C grade all included possibilities of selection bias, measurement basis and attrition bias, while only one study exceeded the control group compared with the experimental group in curative effects. Study 1 showed that acupuncture, electroacupuncture, cupping was better to chlorzoxazone, nifedipine, citicoline in effect of the cervical myelopathy. Study 2 indicated that acupuncture, massage, traditional Chinese medicine were more excited than diclofenac. Study 3 revealed that selective angle traction was supper to traction of zero angle in rate of cure and improvement. Study 4 indicated the effect of traditional Chinese medicine was inferior to mikebao. Above studies did not been stopped for adverse reaction. CONCLUSION: Low quality of above studies mainly originated from absence of a unified curative method, small samples, difference of follow-up time and judgment standard. So more samples, future multicenter and more regular randomized controlled trial should be performed.

Full text (sometimes free) may be available at these link(s):      help

• PDF locator
• publisher