Improving effects of balanced reduction manipulation for cervical physiological curvature and inflammatory response in patients with vertebroarterial cervical spondylosis

Cross-sectional cohort. This study aims to provide an algorithm to estimate Short Form-6D (SF-6D) utilities using data from the Neck Disability Index (NDI), neck pain, and arm pain scores. Although cost-utility analysis is increasingly used to provide information about the relative value of alternative interventions, health state values or utilities are rarely available from clinical trial data. The Neck Disability Index (NDI) and numerical rating scales for neck and arm pain are widely used disease-specific measures in patients with cervical degenerative disorders. The purpose of this study is to provide an algorithm to allow estimation of SF-6D utilities using data from the NDI, and numerical rating scales for neck and arm pain. SF-36, NDI, neck and arm pain rating scale scores were prospectively collected before surgery, at 12 and 24 months after surgery in 2080 patients undergoing cervical fusion for degenerative disorders. SF-6D utilities were computed, and Spearman correlation coefficients were calculated for paired observations from multiple time points between NDI, neck and arm pain scores, and SF-6D utility scores. SF-6D scores were estimated from the NDI, neck and arm pain scores were estimated using a linear regression model. Using a separate, independent dataset of 396 patients in which NDI scores were available, SF-6D was estimated for each subject and compared to their actual SF-6D. The mean age for those in the development sample was 50.4 ± 11.0 years and 33% were male. In the validation sample, the mean age was 53.1 ± 9.9 years and 35% were male. Correlations between the SF-6D and the NDI, neck and arm pain scores were statistically significant (P < 0.0001) with correlation coefficients of 0.82, 0.62, and 0.50, respectively. The regression equation using NDI aloneto predict SF-6D had an R of 0.66 and a root mean square error of 0.056. In the validation analysis, there was no statistically significant difference (P 5 0.961) between actual mean SF-6D (0.49 6 0.08) and the estimated mean SF-6D score (0.49 6 0.08), using the NDI regression model. This regression-based algorithm may be a useful tool to predict SF-6D scores in studies of cervical degenerative disease that have collected NDI but not utility scores.

Neck and back pain are highly prevalent conditions that account for major disability. The Neck Disability Index (NDI) and Oswestry Disability Index (ODI) are the two most common functional status measures for neck and back pain. However, no single instrument exists to evaluate patients with concurrent neck and back pain. The recently developed Total Disability Index (TDI) combines overlapping elements from the ODI and NDI with the unique items from each. This study aimed to prospectively validate the TDI in patients with spinal deformity, back pain, and/or neck pain. This study is a retrospective review of prospectively collected data from a single center. The 14-item TDI, derived from ODI and NDI domains, was administered to consecutive patients presenting to a spine practice. Patients were assessed using the ODI, NDI, and EQ-5D. Validation of internal consistency, test-retest reproducibility, and validity of reconstructed NDI and ODI scores derived from TDI were assessed. A total of 252 patients (mean age 55 years, 56% female) completed initial assessments (back pain, n = 115; neck pain, n = 52; back and neck pain, n = 55; spinal deformity, n = 55; and no pain/deformity, n = 29). Of these patients, 155 completed retests within 14 days. Patients represented a wide range of disability (mean ODI score: 36.3 ± 21.6; NDI score: 30.8 ± 21.8; and TDI score: 34.1 ± 20.0). TDI demonstrated excellent internal consistency (Cronbach's alpha = 0.922) and test-retest reliability (intraclass correlation coefficient = 0.96). Differences between actual and reconstructed scores were not clinically significant. Subanalyses demonstrated TDI's ability to quantify the degree of disability due to back or neck pain in patients complaining of pain in both regions. The TDI is a valid and reliable disability measure in patients with back and/or neck pain and can capture each spine region's contribution to total disability. The TDI could be a valuable method for total spine assessment in a clinical setting, and its completion is less time consuming than that for both the ODI and NDI.

Background The Musculoskeletal Health Questionnaire (MSK-HQ) is a recently developed generic patient-reported outcome measure (PROM), evaluating impacts of musculoskeletal (MSK) conditions on patients’ health. Its scores range 0-56; higher scores indicate better health. Its performance (a) in patients with MSK-pain in primary care, and (b) compared to MSK pain-site reference PROMs, is uncertain. We addressed these uncertainties through secondary analysis of a previous primary-care based study, enrolling 524 patients with shoulder, neck, lower back, knee, or multi-site MSK pain managed by GPs, from 8 West Midlands practices. Methods The study captured the following self-report questionnaire data at 0 and 6 months: MSK-HQ, EQ-5D-5L, Roland-Morris Disability Questionnaire (back pain), Neck Disability Index (neck pain), Shoulder Pain and Disability Index (shoulder pain), Knee Injury and Outcome Score (knee pain), Short-Form-12 (multisite pain). At 6 months, patients self-rated their global change in MSK pain, from -5 (“very much worse”) to + 5 (“completely recovered”). Receiver operating characteristic curves evaluated the ability of 6-month changes in each PROM to discriminate between patients improving/not improving on global change scores. Minimal Clinically Important Differences (MCID) were calculated (cut-off optimising discriminatory sensitivity/specificity). Results Most (60%) reported pain improvements, with mean baseline MSK-HQ scores rising from 29.4 to 37.4 over 6-months. The MSK-HQ had a moderate ability to discriminate between patients improving vs. no change/worsening in MSK pain (area under the curve [AUC] 0.81; 95% CI 0.78-0.85). Its discriminative ability was better than the EQ-5D-3L (AUC 0.68; 95% CI 0.62-0.73) and at least as good as site-specific PROMs (Table). MCID for the 6-month change in MSK-HQ was 5.5 across all patients. Minor variation (&amp;lt;2.0 units) was observed in MSK-HQ MCID across 4/5 pain sites. The MSK-HQ had strong correlations with all PROMs except SF-12 physical/mental component summary scores. Conclusion In patients consulting in primary care with MSK pain, the MSK-HQ appears at least as good as existing pain-site specific PROMs at identifying patients self-reporting pain improvements, and superior to the EQ-5D-5L. Our results support the use of the MSK-HQ in this setting. Disclosures I.C. Scott None. G. McCray None. G. Lancaster None. N.E. Foster None. J.C. Hill None.

Using PROMIS-29 to predict Neck Disability Index (NDI) scores using a national sample of cervical spine surgery patients

154. What PROMIS scores correlate with severe disability in cervical spine surgery

Cerebral Perfusion in Patients With Chronic Neck and Upper Back Pain: Preliminary Observations

309. Patient reported allergies: a marker of preoperative pain and disability in elective spine surgery

Purpose: The purpose of this study was to evaluate the impact of active vibration exercise on the neck pain, disability index, and muscle activity of patients with forward head posture. Methods: A total of 24 patients were randomly assigned to an experimental group or a control group (n=12 each). The experimental group performed active vibration exercise using a flexi-bar for 20 minutes a day, five times a week for four weeks. The study measured patient neck pain using a visual analog scale, neck pain related disability using the neck disability index, and muscle activity using electromyography. Results: The intragroup comparison showed significant differences in the visual analog scale score, neck disability index score and upper trapezius, lower trapezius and serratus anterior muscle activity values among patients in the experimental group. The intergroup comparison showed that differences in the visual analog scale score, neck disability index score and upper trapezius, lower trapezius and serratus anterior muscle activity values in the control group. Conclusion: This study showed that active vibration exercise was effective in improving the neck pain, disability index, and muscle activity of patients with forward head posture.

Joint Mobilization vs Massage for Chronic Mechanical Neck Pain: A Pilot Study to Assess Recruitment Strategies and Estimate Outcome Measure Variability

We compared the feasibility of ultrasound (US)-guided myofascial trigger point (MTrP) injection with that of a blind injection technique following the use of shear wave elastography (SWE) for the measurement of stiffness at the MTrPs in patients with trapezius myofascial pain syndrome (MPS). A total of 41 patients (n = 41) were randomized to either the trial group (n = 21, SWE combined with US-guided injection) or the control group (n = 20, SWE combined with blind injection). At baseline and four weeks, they were evaluated for the manual muscle test (MMT), the range of motion (ROM), pain visual analogue scale (VAS) scores, Shoulder Pain and Disability Index (SPADI) scores and Neck Disability Index (NDI) scores during the abduction, adduction, flexion, extension, external rotation and internal rotation of the shoulder joint. Differences in changes in pain VAS scores, NDI scores and SPADI scores at four weeks from baseline between the two groups reached statistical significance (p = 0.003, 0.012, and 0.018, respectively). US-guided MTrP injection is a more useful modality as compared with a blind injection in patients with MPS.

Purpose: This study was designed to evaluate the clinical efficacy of acupuncture combined with electrotherapy and infrared irradiation for treating neck, shoulder, and low back pain caused by a prolonged sedentary lifestyle. Methods: A total of 160 patients diagnosed with neck, shoulder, and low back pain due to a prolonged sedentary lifestyle from September 2024 to March 2025 were recruited for this study. These patients were randomly allocated to an observation group (n = 80) and a control group (n = 80). The observation group underwent acupuncture therapy, targeting specific acupoints such as Fengchi (GB20), Jianjing (GB21), Dazhui (GV14), and Shenshu (BL23), along with electrotherapy and infrared irradiation. In comparison, the control group received conventional physical therapy. Before and after the treatment, the Visual Analog Scale (VAS) scores, Neck Disability Index (NDI) scores, Japanese Orthopaedic Association (JOA) scores, and clinical efficacy were compared between the two groups. Results: After treatment, the observation group showed significantly greater improvements in VAS scores (2.8 ± 1.1 vs. 4.3 ± 1.4), NDI scores (15.3 ± 4.8 vs. 21.7 ± 5.1), and JOA scores (22.8 ± 3.5 vs. 18.3 ± 3.7) than the control group (P Conclusion: Acupuncture combined with electrotherapy and infrared irradiation has exhibited notable efficacy in effectively relieving the symptoms of neck, shoulder, and low back pain caused by a prolonged sedentary lifestyle. It also aids in improving functional mobility and enhancing the quality of life, showing better therapeutic results compared to conventional physical therapy.

The presence of predominant pain in the arm vs the neck as a predictor of postoperative outcomes after anterior cervical discectomy and fusion (ACDF) has been seldom reported; therefore, the purpose of this study was to determine whether patients with predominant neck pain improve after surgery compared to patients with predominant arm pain or those with mixed symptoms in patients undergoing ACDF for radiculopathy. A retrospective cohort study was conducted on patients who underwent ACDF at a single center from 2016 to 2018. Patients were split into groups based on preoperative neck and arm pain scores: neck (N) pain dominant group (visual analog scale [VAS] neck ≥ VAS arm by 1.0 point); neutral group (VAS neck < VAS arm by 1.0 point); or arm (A) pain dominant group (VAS arm ≥ VAS neck by 1.0 point), using a threshold difference of 1.0 point. Subsequently, individuals were substratified into 2 groups based on the arm to neck pain ratio (ANR): non-arm pain dominant defined as ANR ≤1.0 and arm pain dominant (APD) defined as ANR >1.0. Patient-reported outcome measurements including Neck Disability Index (NDI), Physical Component Score-12, and Mental Component Score (MCS-12) were compared between groups. No significant differences between groups when stratifying patients using a threshold difference of 1.0 point. When stratifying patients using the ANR, those in the APD group had significantly higher postoperative MCS-12 (P = 0.008) and NDI (P = 0.011) scores. In addition, the APD group showed a greater magnitude of improvement for MCS-12 and NDI scores (P = 0.043 and P = 0.038, respectively). Multiple linear regression showed that the A and the APD groups were both independent predictors of improvement in NDI. Patients with dominant arm pain showed significantly greater improvement in terms of MCS-12 and NDI scores compared to patients with dominant neck pain. To compare the impact of ACDF on arm and neck pain in the context of cervical radiculopathy using patient-reported outcome measures as an objective measurement.

Background: The prevalence of neck pain and neck dysfunction is high in general population. However, there is little literature on the relationship and factors affecting neck pain and neck dysfunction. Objective: To investigate the correlation between neck and shoulder pain, headaches, neck and shoulder dysfunction, and sleep quality in adults with chronic neck pain, and factors affecting neck pain and neck dysfunction. Design: Cross-sectional study Methods : The sample included 114 subjects, who had complained of chronic neck pain for more 12 weeks. We conducted a Pearson’s correlation between neck and shoulder pain, headaches, neck and shoulder dysfunction and sleep quality and a regression analysis of the related variables, thereby ana­lyzing factors affecting neck pain and neck dysfunction. Results : In the present study, in adults with chronic neck pain, neck pain was positively correlated with the Neck Disability Index (NDI), Shoulder Pain and Disability Index (SPADI)-Pain score, and SPADI-Total score (p<.05). The NDI was positively correlated with neck pain, SPADI-Pain score, and SPADI-Total score, as well as with Pittsburgh Sleep Qulity Index(PSQI-K) (p<.05). Among the factors affecting neck pain, shoulder disability as assessed by the SPADI was a significantly associated with neck pain, while shoulder pain and shoul­der disability determined by the SPADI were identified as significant variables among the factors affecting neck disability. Conclusion : These results indicated that as neck pain worsened , shoulder pain and neck and shoulder dysfunction also increased, which suggested that shoulder disability affected neck pain. In addition, as the neck dysfunction increased, neck pain and shoulder pain and shoulder dysfunction increased, and sleep quality deteriorated, which suggested that shoulder pain and shoulder disability affected neck disability.

ObjectiveThe Neck Disability Index (NDI) is a self-rated disability tool originally developed for whiplash-associated disorders and validated in cervical musculoskeletal conditions. It is now commonly used to assess neck disability in migraine, but it is unknown whether NDI scores relate to migraine and hypersensitivity, cervical musculoskeletal dysfunction, or both. This single-blinded observational study aimed to determine whether the presence of cervical musculoskeletal dysfunction, migraine features, and hypersensitivity predict NDI scores and whether alternate versions of the NDI (NDI-physical, NDI-8, NDI-5) relate more to cervical musculoskeletal dysfunction.MethodsMigraine and neck pain features, the Headache Impact Test (HIT-6), NDI, Allodynia Symptom Checklist (ASC12), and pressure pain thresholds were assessed in 104 participants with migraine and neck pain, 45 previously identified with cervical musculoskeletal dysfunction and 59 without. The NDI score was regressed on the presence or absence of cervical dysfunction, migraine features, HIT-6, total pressure pain threshold, and ASC12 while accounting for neck pain features. The presence of cervical dysfunction was regressed on the scores of NDI versions.ResultsThe ASC12 (standardized ß = 0.20) and HIT-6 (standardized ß = 0.18) were significantly predictive of total NDI score, as were neck pain intensity (standardized ß = 0.32) and frequency (standardized ß = 0.44). No scores from alternate NDI versions related to cervical dysfunction.ConclusionThe NDI score is a complex measure of neck disability influenced by migraine disability and hypersensitivity beyond the presence of cervical musculoskeletal dysfunction. This has implications for the clinical interpretation of NDI scores in patients with migraine.ImpactMany patients with migraine and neck pain report neck disability; therefore, it is important to understand if migraine impacts neck disability. The results of this study indicate that clinicians need to consider migraine-related disability and hypersensitivity when managing neck disability in this population.

Objective: Several muscles surrounding neck are vital not only for neck motion, but for upper extremities motions as well. Neck pain would affect neck and shoulder disability. The Neck Disability Index (NDI), Shoulder Pain and Disability Index (SPADI), and Visual Analogue Scale (VAS) are increasingly used to evaluate treatment effectiveness after chronic neck pain. The purpose of this study was to analyze the correlation of neck pain, shoulder pain, and quality of life in patients with chronic neck pain. Design: Cross-sectional study. Methods: Forty-three patients with neck pain participated in this study. Participants were instructed to place a mark on each item of three clinical measures that best represented their experience of his/her neck and shoulder problem over the last week. The outcome measures of the study were NDI, SPADI, and VAS for neck and shoulder pain and disability. Results: The NDI was significantly correlated with the VAS-Neck, SPADI-Pain, SPADI-Disability, SPADI-Total, and VAS-Shoulder (p<0.05). The VAS-Neck was significantly correlated with the VAS-Neck, SPADI-Pain, SPADI-Disability, SPADI- Total, and VAS-Shoulder (p<0.05). The SPADI-Total was significantly correlated with the NDI, VAS-Neck, SPADI-Pain, SPADI- Disability, and VAS-Shoulder (p<0.05). The SPADI-Pain was significantly correlated with the NDI, VAS-Neck, SPADI- Disability, SPADI-Total, and VAS-Shoulder (p<0.05). The SPADI-Disability was significantly correlated with the NDI, VAS- Neck, SPADI-Total, SPADI-Pain, and VAS-Shoulder (p<0.05). The VAS-Shoulder was significantly correlated with the NDI, VAS-Neck, SPADI-Pain, SPADI-Disability, and SPADI-Total (p<0.05). Conclusions: Neck disability in patients with chronic neck pain should be considered with disability and pain of the shoulder.