Traditional Chinese Medicine treatment for postoperative axial symptoms of cervical spondylotic myelopathy: a systematic review

Abstract

Background: Axial symptoms (AS) represent one of the primary complications after cervical spondylotic myelopathy (CSM) surgery. Traditional Chinese Medicine (TCM), as a complementary and alternative therapy, is widely used in the treatment of postoperative AS in CSM. However, it lacks standardised treatment protocols, uniform therapeutic criteria, assessment methods and a sufficiently in-depth understanding of its mechanisms of action. These shortcomings impact the credibility of TCM treatment in clinical practice.

Methods and analysis: We will conduct comprehensive searches, both manual and electronic, on literature published up to 31 July 2024, and database searches will commence after the publication of this agreement, with an estimated commencement date of 1 October 2024 and the end date of 31 March 2025, without language restrictions. Key databases such as MEDLINE, PubMed, Embase, Web of Science, Cochrane Library, WHO International Clinical Trial Registration Platform, China National Knowledge Network, China Biomedical Literature Database, China Scientific Journal Database and Wanfang Database will be explored. In addition, we will include resources such as library journals and conference abstracts. After identifying and screening all randomised controlled trials focused on TCM for postoperative AS of CSM, the two investigators will conduct a meta-analysis of the included studies. The results will be summarised as the risk ratio for binary data and the standardised or weighted average difference for continuous data.

Ethics and dissemination: Ethical approval is not required since this review does not involve individual patient data. The review's findings will provide clinicians with evidence on using TCM treatment for AS post-CSM surgery, disseminated through peer-reviewed publications or conferences.

Prospero registration number: CRD42024505160.

Keywords: COMPLEMENTARY MEDICINE; Musculoskeletal disorders; Rehabilitation medicine; Spine; Systematic Review.

Figure 1. Flow diagram of studies identified. CBM, China Biomedical Literature Database; CNKI, China National Knowledge Network; ICTRP, WHO International Clinical Trial Registration Platform; TCMD, Traditional Chinese Medicine Database; VIP, China Scientific Journal Database and Wanfang Database.