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首页> 外文期刊>Neurosurgical focus >Delayed diagnosis of cervical spondylotic myelopathy by primary care physicians
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Delayed diagnosis of cervical spondylotic myelopathy by primary care physicians

机译：初级保健医生延迟诊断宫颈脊髓囊肿病理

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Object: A retrospective study analyzing medical files of patients who had undergone surgical management for cervical spondylotic myelopathy (CSM) at a single tertiary hospital was performed to determine the time needed by community care physicians to reach a diagnosis of CSM in patients presenting with typical myelopathic signs and symptoms, and to establish the reasons for the delayed diagnosis when present. Previous studies have documented that early diagnosis and surgical treatment of CSM may improve patients' neurological as well as general outcome. However, patients complaining of symptoms compatible with CSM may undergo lengthy medical investigations and treatments by community-based physicians before a correct diagnosis is made. The authors have found no published data on the process and time frame involved in attaining a diagnosis of CSM in the community setting. Methods: The medical records of 42 patients were retrospectively reviewed for demographic data, symptoms, time to diagnosis, physician specialty, number of visits involved in the diagnostic process, and neurological status prior to surgery. Results: The mean time delay from initiation of symptoms to diagnosis of CSM was 2.2 ± 2.3 years. The majority of symptomatic patients (90.4%) initially presented to a family practitioner (69%) or an orthopedic surgeon (21.4%), with fewer patients (9.6%) referring to other disciplines (for example, the emergency department) for initial care. In contrast, the diagnosis of CSM was most often made by neurosurgeons (38.1%) and neurologists (28.6%), and less frequently by orthopedic surgeons (19%) or family physicians (4.8%). Conclusions: The diagnosis of CSM in the community is frequently delayed, leading to late referral for surgery. A higher index of suspicion for this debilitating entity is required from family practitioners and community-based orthopedic surgeons to prevent neurological sequelae.
机译：对象：分析在单个高等医院的宫颈脊椎病（CSM）经历手术管理的患者的回顾性研究，以确定社区护理医生患者诊断患者患者患有典型的肌钙病症状和症状，并建立当前延迟诊断的原因。以前的研究表明，CSM的早期诊断和外科治疗可能会改善患者的神经系统以及一般性结果。然而，在正确的诊断之前，抱怨与CSM兼容的症状可能会受到社区的医生进行冗长的医学调查和治疗。作者发现没有关于在社区设置中诊断CSM的过程和时间帧上的发布数据。方法：42名患者的病历记录回顾性审查人口统计数据，症状，诊断时间，医生专业，诊断过程中涉及的诊断过程的次数，以及手术前的神经系统。结果：对CSM诊断症状的平均时间延迟为2.2±2.3岁。大多数症状患者（90.4％）最初呈现给家庭从业者（69％）或骨科外科医生（21.4％），较少的患者（9.6％）提及其他学科（例如，急诊部）进行初始护理。相比之下，CSM的诊断最常是由神经外科医生（38.1％）和神经学家（28.6％）制成的，并且透明的外科医生（19％）或家庭医生（4.8％）较少。结论：社区中CSM的诊断经常推迟，导致手术转诊。家庭从业者和基于社区整形外科医生需要更高的这种衰弱实体的怀疑指数，以预防神经系统后遗症。

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