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Journal of the American Board of Family... 2020Cervical spondylotic myelopathy (CSM) is a neurologic condition that develops insidiously over time as degenerative changes of the spine result in compression of the... (Review)
Review
Cervical spondylotic myelopathy (CSM) is a neurologic condition that develops insidiously over time as degenerative changes of the spine result in compression of the cord and nearby structures. It is the most common form of spinal cord injury in adults; yet, its diagnosis is often delayed. The purpose of this article is to review the pathophysiology, natural history, diagnosis, and management of CSM with a focus on the recommended timeline for physicians suspecting CSM to refer patients to a spine surgeon. Various processes underlie spondylotic changes of the canal and are separated into static and dynamic factors. Not all patients with evidence of cord compression will present with symptoms, and the progression of disease varies by patient. The hallmark symptoms of CSM include decreased hand dexterity and gait instability as well as sensory and motor dysfunction. magnetic resonance imaging is the imaging modality of choice in patients with suspected CSM, but computed tomography myelography may be used in patients with contraindications. Patients with mild CSM may be treated surgically or nonoperatively, whereas those with moderate-severe disease are treated operatively. Due to the long-term disability that may result from a delay in diagnosis and management, prompt referral to a spine surgeon is recommended for any patient suspected of having CSM. This review provides information and guidelines for practitioners to develop an actionable awareness of CSM.
Topics: Adult; Cervical Vertebrae; Humans; Magnetic Resonance Imaging; Spinal Cord Compression; Spinal Cord Diseases; Spondylosis
PubMed: 32179614
DOI: 10.3122/jabfm.2020.02.190195 -
Neurology India 2021
Topics: Cervical Vertebrae; Humans; Spondylosis
PubMed: 34169850
DOI: 10.4103/0028-3886.319240 -
BMC Musculoskeletal Disorders Mar 2020Cervical radiculopathy is usually caused by disc herniation or spondylosis. The prognosis is expected to be good in most patients, but there is limited scientific... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
Cervical radiculopathy is usually caused by disc herniation or spondylosis. The prognosis is expected to be good in most patients, but there is limited scientific evidence on the indications for nonsurgical and surgical treatments. The aim of the present study is to evaluate and compare the effectiveness of surgical and nonsurgical treatment in two trials - including disc herniation and spondylosis, respectively, and to evaluate factors that contribute to better decision making.
METHODS/DESIGN
Patients with disabling radicular arm pain and MRI-proven cervical disc herniation or spondylosis will be randomised to receive nonsurgical or surgical treatment. The follow-up period is one year and the sample size is estimated to be 50 for each arm in the two trials, giving a total of 200 patients. The primary outcomes are the Neck Disability Index and arm pain. Secondary outcomes include neck pain; EQ-5D and costs to evaluate cost-effectiveness; prognostic factors; CT and MRI scans, to estimate intervertebral foraminal area and nerve root compression; and the expected minimal improvement for willingness to undergo treatment.
DISCUSSION
The outcomes of this study will contribute to better decision making in the treatment of cervical radiculopathy.
TRIAL REGISTRATION
This study has been registered at ClinicalTrials.gov as NCT03674619, on September 17, 2018.
Topics: Adult; Aged; Cervical Vertebrae; Conservative Treatment; Decompression, Surgical; Female; Follow-Up Studies; Humans; Intervertebral Disc Degeneration; Intervertebral Disc Displacement; Male; Middle Aged; Pain Measurement; Radiculopathy; Single-Blind Method; Spondylosis; Treatment Outcome; Young Adult
PubMed: 32178655
DOI: 10.1186/s12891-020-3188-6 -
Medicine Nov 2019Cervical spondylosis radiculopathy (CSR) is often described as neck pain accompanied with radiating pain and neurologic symptoms, such as numbness, muscle weakness, and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Cervical spondylosis radiculopathy (CSR) is often described as neck pain accompanied with radiating pain and neurologic symptoms, such as numbness, muscle weakness, and diminished reflexes, in 1 or both upper extremities. As people's lifestyle changes and the population ages, the incidence of CSR continues to increase. Many clinical trials have proven that acupuncture and chiropractic has a significant effect in the treatment of CSR. In this systematic review, we aim to evaluate the effectiveness and safety of acupuncture and chiropractic for CSR.
METHODS
We will search PubMed, Cochrane Library, AMED, EMbase, WorldSciNet; Nature, Science online and China Journal Full-text Database, China Biomedical Literature CD-ROM Database, and related randomized controlled trials included in the ChinaResources Database. The time is limited from the construction of the library to February, 2019. We will use the criteria provided by Cochrane 5.1.0 for quality assessment and risk assessment of the included studies, and use the Revman 5.3 and Stata13.0 software for meta-analysis of the effectiveness, recurrence rate, and symptom scores of CSR.
TRIAL REGISTRATION NUMBER
CRD42019119941.
Topics: Acupuncture Therapy; Humans; Manipulation, Chiropractic; Radiculopathy; Spondylosis; Treatment Outcome
PubMed: 31770206
DOI: 10.1097/MD.0000000000017974 -
Biomolecules & Biomedicine Sep 2023Cervical spondylosis is a widespread medical condition that significantly impacts patients' quality of life. Treatment options include surgical and conservative... (Review)
Review
Cervical spondylosis is a widespread medical condition that significantly impacts patients' quality of life. Treatment options include surgical and conservative approaches, with conservative treatment often being the preferred choice. Rehabilitation therapy is an essential component of conservative treatment, and advancements in technology have the way to the development of new physiotherapy techniques. The effectiveness of treatment largely hinges on the patient's ability to improve their dysfunction. This study aims to provide valuable insights into the use of new physical therapy techniques, such as Sling Exercises Training (SET), fascia manipulation, muscle energy technique (MET), and proprioceptive neuromuscular facilitation (PNF), that aid the rehabilitation of cervical spondylosis. By scrutinizing the current research status of these techniques, this study aims to present innovative ideas enhancing the rehabilitation process and outcomes for patients suffering from cervical spondylosis.
Topics: Humans; Quality of Life; Spondylosis; Physical Therapy Modalities; Decompression, Surgical; Muscle Stretching Exercises
PubMed: 37212037
DOI: 10.17305/bb.2023.9049 -
Medicine Jan 2020The pathogenesis of cervical spondylotic is degenerative changes of the cervical intervertebral disc, or bone hyperplasia of the posterior and hook joints, and...
BACKGROUND
The pathogenesis of cervical spondylotic is degenerative changes of the cervical intervertebral disc, or bone hyperplasia of the posterior and hook joints, and instability of the joints of the cervical vertebrae. It causes the nerve roots to be stimulated and oppressed. The clinical manifestations are the sensation, movement, and reflex disorder of the cervical spinal nerve roots that are stimulated and oppressed, especially the numbness and pain of the neck, shoulders, upper limbs, and fingers. In this systematic review, we aimed to evaluate the efficacy and safety of acupuncture and chiropractic in the treatment of cervical spondylotic.
METHODS AND ANALYSIS
We will search for PubMed, Cochrane Library, AMED, Embase, WorldSciNet; Nature, Science online and China Journal Full-text Database (CNKI), China Biomedical Literature CD-ROM Database (CBM), and related randomized controlled trials included in the China Resources Database. The time is limited from the construction of the library to September 2019. We will use the criteria provided by Cochrane 5.1.0 for quality assessment and risk assessment of the included studies, and use the RevMan 5.3 and Stata 13.0 software for meta-analysis of the effectiveness, recurrence rate, and symptom scores of cervical spondylotic.
ETHICS AND DISSEMINATION
This systematic review will evaluate the efficacy and safety of acupuncture and chiropractic for cervical spondylotic. Because all of the data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process trial.
Topics: Humans; Acupuncture Therapy; Manipulation, Chiropractic; Radiculopathy; Spondylosis; Meta-Analysis as Topic; Systematic Reviews as Topic
PubMed: 32000386
DOI: 10.1097/MD.0000000000018851 -
BMC Musculoskeletal Disorders Oct 2019Cervical proprioception is critical in the maintenance of posture and movements, so its assessment in different cervical conditions has gained importance in recent...
BACKGROUND
Cervical proprioception is critical in the maintenance of posture and movements, so its assessment in different cervical conditions has gained importance in recent clinical practice. Studies reporting this assessment in subjects with cervical spondylosis (CS) have not previously been investigated. The goals of the study are (1) comparison of joint position error (JPE) in subjects with CS to healthy control group. (2) Correlation of neck pain intensity to cervical proprioception in patients with CS.
METHODS
In a Cross-sectional study, 132 subjects with CS and 132 healthy age-matched control subjects were evaluated for cervical JPE with the cervical range of motion device. The subjects were blindfolded and repositioned their heads to a target position, which was determined by the examiner previously and their repositioning accuracy (absolute error in degrees) was measured in the frontal (flexion and extension) and transverse planes (left rotation and right rotation). The CS subjects resting neck pain intensity was assessed using visual analog scale (VAS).
RESULTS
CS subjects showed statistically significantly larger JPEs compared to healthy control subjects in all the directions tested (flexion - 95% CI = 2.38-3.55, p < 0.001, extension - 95% CI =3.26-4.33, p < 0.001, left rotation - 95% CI = 2.64 - 3.83, p < 0.001, right rotation - 95% CI = 3.77-4.76, p < 0.001). The mean JPE errors in the CS group ranged from 6.27° to 8.28° and in the control group ranged from 2.36° to 4.48°. Pearson's correlation coefficient showed a significant and positive relationship between neck pain intensity and cervical proprioception (p ≤ 0.001).
CONCLUSIONS
Proprioception is impaired in subjects with CS when compared to healthy control group. Higher pain intensity was associated with greater cervical JPE in patients with CS.
Topics: Adult; Cervical Vertebrae; Cross-Sectional Studies; Female; Head Movements; Healthy Volunteers; Humans; Male; Middle Aged; Neck; Neck Pain; Pain Measurement; Posture; Proprioception; Range of Motion, Articular; Severity of Illness Index; Spondylosis
PubMed: 31615495
DOI: 10.1186/s12891-019-2846-z -
Medicine Jun 2018This study aimed to evaluate the effectiveness and safety of percutaneous neuromuscular electrical stimulation (PNMES) for treating neck pain in patients with cervical... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
This study aimed to evaluate the effectiveness and safety of percutaneous neuromuscular electrical stimulation (PNMES) for treating neck pain in patients with cervical spondylosis (CS).
METHODS
One hundred and twenty four patients with neck pain of CS were included, and then they were randomly divided into a PNMES group and a control group in a ratio of 1:1. All patients received PNMES or sham PNMES 30 minutes daily, 3 times weekly for 12 weeks. The primary outcome was assessed by the visual analog scale (VAS). The secondary outcomes were evaluated by the cervical range of motion (ROM), neck disability index (NDI) score, as well as the adverse events (AEs). All outcome measurements were measured at the end of 12-week treatment, and 4-week follow-up after treatment.
RESULTS
At the end of the 12-week treatment, and 4-week follow-up, the patients receiving PNMES exhibited more decrease in the mean VAS (P < .01), and NDI (P < .01) respectively, compared with the patients receiving sham PNMES. Additionally, the increase in the mean ROM was also significantly higher in the PNMES group than that in the sham PNMES group at the end of the 12-week treatment, and 4-week follow-up, respectively (P < .01). No AEs were found in either group.
CONCLUSIONS
The results of this study demonstrated that PNMES is more effective than Sham PNMES for neck pain relief in patients with CS.
Topics: Adult; Cervical Vertebrae; Double-Blind Method; Electric Stimulation; Female; Humans; Male; Middle Aged; Neck; Neck Pain; Pain Management; Range of Motion, Articular; Spondylosis; Transcutaneous Electric Nerve Stimulation; Treatment Outcome; Visual Analog Scale
PubMed: 29952946
DOI: 10.1097/MD.0000000000011080 -
MSMR Dec 2021Osteoarthritis (OA) is the most common adult joint disease and accounts for significant morbidity burdens among U.S. civilian and military populations. During 2016-2020,...
Osteoarthritis (OA) is the most common adult joint disease and accounts for significant morbidity burdens among U.S. civilian and military populations. During 2016-2020, the crude overall rates of incident OA and spondylosis diagnoses among U.S. active component service members were 630.9 per 100,000 person-years (p-yrs) and 958.2 per 100,000 p-yrs, respectively. Crude annual rates of both conditions decreased markedly from 2016 through 2020 with declines evident in all of the demographic and military subgroups examined. Compared to their respective counterparts, crude overall rates of OA diagnoses were highest among male service members, those aged 35 or older, non-Hispanic Black service members, Army members, and those working in health care occupations. Crude overall rates of spondylosis diagnoses were highest among those aged 30 or older, non-Hispanic White and non-Hispanic Black service members, Army members, and those in health care and communications/intelligence occupations. More than two-thirds of all incident OA diagnoses involved the knee (38.8%) or shoulder (28.4%). Differences in anatomic site-specific rates of OA were apparent by sex, race/ethnicity group, service, and military occupation. Additional research to identify military-specific equipment and activities that increase the risk of acute and chronic damage to joints would be useful to develop, test, and implement practical and effective countermeasures against OA and spondylosis among military members in general and those in high-risk occupations specifically.
Topics: Adult; Ethnicity; Humans; Male; Military Personnel; Osteoarthritis; Spondylosis
PubMed: 35320662
DOI: No ID Found -
European Spine Journal : Official... Mar 2011Cervical spondylotic amyotrophy is characterized with weakness and wasting of upper limb muscles without sensory or lower limb involvement. Two different mechanisms have... (Review)
Review
Cervical spondylotic amyotrophy is characterized with weakness and wasting of upper limb muscles without sensory or lower limb involvement. Two different mechanisms have been proposed in the pathophysiology of cervical spondylotic amyotrophy. One is selective damage to the ventral root or the anterior horn, and the other is vascular insufficiency to the anterior horn cell. Cervical spondylotic amyotrophy is classified according to the most predominantly affected muscle groups as either proximal-type (scapular, deltoid, and biceps) or distal-type (triceps, forearm, and hand). Although cervical spondylotic amyotrophy always follows a self-limited course, it remains a great challenge for spine surgeons. Treatment of cervical spondylotic amyotrophy includes conservative and operative management. The methods of operative management for cervical spondylotic amyotrophy are still controversial. Anterior decompression and fusion or laminoplasty with or without foraminotomy is undertaken. Surgical outcomes of distal-type patients are inferior to those of proximal-type patients.
Topics: Humans; Muscle, Skeletal; Muscular Atrophy; Spondylosis; Upper Extremity
PubMed: 20694735
DOI: 10.1007/s00586-010-1544-1