In the era of rapid information development, people are dependent on computers and mobile phones for life, entertainment, and work. Currently, the onset of CDH is seriously increasing in the younger population. Changes in the morphological structure of the cervical spine are closely related to body posture in daily life and work. Head, neck, and shoulder activities directly affect the physiological function and morphological degeneration of each cervical segment[20, 21]. Clinical studies have shown that the incidence of CDH is closely related to the internal and external imbalance of the cervical spine. Therefore, the restoration of the dynamic and static balance of the cervical spine is the key to effective treatment and prevention of CDH. During hospitalization and after discharge, guided interventions involving the patient’s functional exercise of the cervical spine can help to achieve significant clinical effectiveness[21, 23]. After discharge, the patient's compliance decreases or disappears, and the early relief of symptoms can cause the patient to forget that good work and life habits are the basis for maintaining the normal function of the cervical spine. Some patients gradually neglect good behavioral habits and cervical functional exercise, leading to the recurrence of disease symptoms or adjacent segment disc herniation. This study targeted patients with CDH and used whole course integrated management of follow-up evaluation guidance to achieve an ideal clinical management effect.
The conventional nursing management mode leads to information asymmetry in medical care, doctor-patient care and nurse-patient care, and there are several contradictions and inconsistencies. This causes the patient to distrust the doctor and the nurse and even to not cooperate with the treatment. The whole course integrated management mode is a new type of treatment and rehabilitation management mode that breaks with the traditional nursing mode.[12, 15] This new model departs from the traditional conservative "subordination model" of medical care, doctor-patient care and nurse-patient care. Management teams are formed by the doctors in charge and responsible nurses, who participate in the whole process of patients' recovery and nursing during the perioperative period and after discharge[13–15]. As a result, many hospitals have developed new nursing modes, namely, the continuous treatment mode, the family doctor management mode and the participation mode, using modern information platforms (such as QQ groups and WeChat groups) to form a new system of seamless docking and three-dimensional integration among doctors, nurses and patients[26, 27]. The classic procedure for CDH is cervical discectomy, bone graft fusion and internal fixation. However, long-term clinical follow-up has revealed concerns related to the complications associated with this approach and the acceleration of the degeneration of adjacent segments, in addition to the reappearance of related symptoms and signs of cervical spondylosis [5–7]. Full-endoscopic spinal surgery not only avoids the deficiency of open surgery but also fully preserves the biomechanical stability of the spine[28, 29]. However, patients and nonspecialists have little knowledge of modern spinal full-endoscopic surgery techniques, and they are reluctant to undertake full-endoscopic treatment at an early stage. For patients with CDH who need surgical treatment, because local disc herniation results in limited compression of the spinal cord, percutaneous full-endoscopic surgery not only achieves the purpose of percutaneous targeted removal of disc tissue and spinal decompression but also has a better cosmetic effect, reduces the complications associated with the open surgical approach, better maintains the biomechanical stability of the spine, and avoids the acceleration of degeneration in adjacent segments[30, 31]. Through the integrated management model, doctors, nurses and patients have a consistent understanding of the percutaneous spinal full-endoscopic procedure, especially because of the physician's explanation of the etiology, mechanism, operation, spinal cord nerve function recovery and cervical biomechanical stability. Through this, the responsible nurses fully understand and can cooperate with the doctor's orders and actively carry out health education and psychological care for the patients. This alleviates patients’ worry and fear because they recognize, understand, and voluntary choose percutaneous full-endoscopic treatment and have increased confidence.
The results showed that there was no significant difference between the two groups, p > 0.05, indicating that the newly developed percutaneous spinal full-endoscopic surgery was effective and feasible. The compliance rate in the experimental group was better than that in the control group. The postoperative VAS and JOA scores were significantly better than the preoperative scores (p < 0.05). There was no statistically significant difference in the JOA and VAS scores between the two groups, p > 0.05. An integrated management model of the whole course enables CDH patients to receive percutaneous endoscopic treatment and obtain effects consistent with the classical surgical procedure while avoiding or significantly reducing the complications associated with that approach; it also improves the patient compliance rate, significantly reduces the length of hospital stay, and reduces the recurrence rate of symptoms[32–34]. Through the integrated management of the whole course, we can promote the consistency of medical and health education, improve the compliance of CDH patients so that they actively cooperate with the treatment, cultivate and maintain good living and work habits, and strengthen awareness of maintaining the health of the cervical spine [3,14,24]. The establishment of this new health education model of medical cooperation strengthens the sense of responsibility, makes the personnel in each management group be invested and actively participate, ensures the safety of medical treatment and nursing, avoids the occurrence of medical errors and accidents, and improves the satisfaction of clinicians and patients with nursing work [25,26]. It also promotes the development of new medical technology, effectively reduces the average length of hospital stay and speeds up the turnover rate of hospital beds. Moreover, it is beneficial for actively carrying out the training and examination of medical staff, encouraging doctors and nurses to stay up-to-date on the frontier of knowledge in their specialty, achieving common progress and enhancing the building of subject competence [25,32].
The whole-process integrated management model, as a new type of clinical medical cooperation mode, has achieved good clinical results in a certain professional environment. It is restricted by the degree of cooperation and harmony between medical and nursing staff, the training and assessment of medical and nursing staff, the understanding of leadership and the degree of support[32, 34]. Its wide application in the clinic still needs to be explored. In addition, considering the rehabilitation needs of different diseases, for some special patients, the whole-process integrated management model can be extended to cooperation with dietitians, rehabilitators, pharmacists and other multi-professional personnel to discuss and optimize the management plan for the rehabilitation of patients during hospitalization and after discharge[33–35].