Cervical Intervertebral Disc Research Articles

Clinical and imaging findings in dogs with nerve root signature associated with cervical intervertebral disc herniation.

Intervertebral disc herniation (IVDH) is the most common spinal cord disease in dogs. Little information is available regarding the clinical presentation of nerve root signature (NRS) associated with cervical IVDH. To detail the clinical and magnetic resonance imaging (MRI) findings in dogs with NRS associated with cervical IVDH. Forty-seven client-owned dogs presenting with thoracic limb NRS and MRI confirmed IVDH. Medical records from 2010 to 2020 were retrospectively reviewed for dogs that met inclusion criteria. Imaging studies were evaluated by 2 individuals to characterize location and severity of neural tissue compression. Chondrodystrophoid dogs comprised the majority of the study cohort, with dachshund the most common breed (n = 10). Three-quarters of dogs were ≥7 years of age. Interobserver agreement was moderate or good for all of the imaging variables evaluated. The C6-C7 intervertebral disc space was significantly overrepresented (P = .01), comprising 32% (15/47) of the affected discs. However, 42% (20/47) of cases involved C2-C3 though C4-C5 disc sites. Disc material was more frequently located laterally compared to medially within the vertebral canal (P = .0005), and to be associated with compression of the nerve root at the level of the intervertebral foramen (P = .012). NRS is most commonly associated with lateralized or foraminal cervical disc herniations. It is most prevalent with C6-C7 intervertebral disc involvement, suggesting that there might be unique anatomic factors that contribute to development of NRS at this site, but can be a clinical manifestation of IVDH occurring anywhere along the cervical spine.

Examination of annulus fibrosus and nucleus pulposus in cervical and lumbar intervertebral disc herniation patients by scanning acoustic microscopy, scanning electron microscopy and energy dispersive spectroscopy.

Intervertebral disc herniation (IVDH) is observed in humans as a result of the alteration of annulus fibrous (AF) and nucleus pulposus (NP) tissue compositions in intervertebral discs. In this study, we studied the feasibility of scanning acoustic microscopy (SAM), scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) in characterizing the herniated segments of AF and NP tissues from male and female patients. SAM determined the acoustic property variations in AF and NP tissues by calculating the acoustic impedance values of samples of 15 patients. SEM obtained higher resolution images and EDS made elemental analysis of the specimen. Consequently, we suggest that these techniques have the potential to be combined for the investigation and removal of the disrupted AF and NP tissues with micrometer resolution in clinics.

Clinical presentation, magnetic resonance imaging findings, and outcome of 80 Dachshunds with cervical intervertebral disc extrusion.

Large clinical studies regarding cervical intervertebral disc extrusion (IVDE) in Dachshunds are lacking. This retrospective multicentric study therefore aims to describe the clinical features, magnetic resonance imaging (MRI) findings and outcomes of Dachshunds diagnosed with cervical IVDE. Medical records of Dachshunds with cervical IVDE were reviewed for signalment, onset of clinical signs, neurological examination, MRI features, treatment and outcome. Eighty Dachshunds were included in the study, mostly ambulatory (55% grade 1 and 33% grade 2) and without nerve root signature (85% of cases) on presentation. Information on coat type was available for 56% of dogs; specifically, 41% were smooth-haired, 9% were long-haired and 6% were wire-haired Dachshunds. There were 29 (36%) neutered female, 27 (34%) male entire, 15 (19%) male neutered and 9 (11%) entire female dogs. The onset of clinical signs was most often >48 h (84%). The most common intervertebral disc space affected was C2-C3 (38%) and foraminal IVDEs were reported in 14% of dogs. A foraminal IVDE was diagnosed in only 25% of dogs presented with nerve root signatures. Most dogs (77.5%) were treated surgically. In this group, a higher body condition score on presentation and a higher mean spinal cord compression ratio calculated on MRI were directly and moderately associated with a longer hospitalization time (r = 0.490 p = 0.005 and r = 0.310 p = 0.012, respectively). The recovery time was longer in dogs with an onset of clinical signs <24 h or 24-48 h compared to those with an onset of clinical signs >48 h (3.1 ± 6.5 days versus 1.6 ± 6.2, p < 0.001) in both medically and surgically treated groups. Data about the outcome was available for 83% of dogs. Eighty percent of the entire population of dogs was considered to have completely returned to normal. There was no association between the therapeutic choice (surgical versus medical management) and the outcome of the dogs included in this study.

Macleaya Extract versus Pregabalin Therapeutic Effectiveness for Neuropathic Pain in Dogs.

Dogs suffer from neuropathic pain due to several neurological disorders, particularly intervertebral disc disease. We aimed to identify alternative therapeutics for neuropathic pain relief in dogs by comparing the treatment efficacy of pregabalin and Macleaya extract against neuropathic pain from cervical spinal hyperesthesia caused by intervertebral disc disease in dogs. We evaluated 10 dogs suffering from cervical intervertebral disc disease for neuropathic pain using the filament von Frey aesthesiometer (VFA). The dogs were randomly divided into two groups, G1 (n = 5) was treated with 4 mg/kg of pregabalin/12 hours orally for 14 days, and G2 (n = 5) was treated with 15 mg/kg Macleaya extract once daily orally for 14 days. To detect neuropathic pain, the VFA was used to measure the sensory threshold (ST) on days 0, 7, and 14. The results revealed decreases in all ST outcomes with no significant differences between the groups on day 14 posttreatment, as well as a decrease in the severity of neurological disease in both groups on day 7 posttreatment. No significant differences were detected in hematological and biochemical profiles (alanine aminotransferase (ALT), alkaline phosphatase (ALP), serum creatinine (SCR), urea nitrogen (BUN), and total protein (TP)) in both groups between pre- and posttreatment were not significantly different. The Macleaya extract can reduce neuropathic pain in a similar pattern to pregabalin. Macleaya extract may be effective for the treatment of neuropathic pain in dogs with spinal hyperesthesia.

Effects of Cartilage Endplate Degeneration on Metabolic Transport and Biomechanical Responses of Cervical Intervertebral Discs

Effects of Cartilage Endplate Degeneration on Metabolic Transport and Biomechanical Responses of Cervical Intervertebral Discs

Non-surgical treatment of the cervical intervertebral disc disease in a dog with Chiari-like malformation

Non-surgical treatment of the cervical intervertebral disc disease in a dog with Chiari-like malformation

Radiological and anatomical evaluation of the cervical spinal cord, spinal canal, and intervertebral disc morphometry in healthy adults

Purpose: The aim of this study was to examine the normal values of the cervical spinal cord, spinal canal, and intervertebral disc morphometry of healthy subjects in this study &#x0D; Materials and Methods: Cervical magnetic resonance imaging of 83 healthy subjects were examined retrospectively. The anterior and posterior height of each cervical vertebra body, anterior and posterior height of each intervertebral disc between C3-T1, and spinal canal and cord diameters were measured. Additionally, the height ratios of the cervical vertebra body and intervertebral disc were calculated.&#x0D; Results: There was no significant difference between genders in spinal cord diameters from C1 to C7, whereas there was a significant difference between genders in spinal canal diameters from C1 to C4. There were significant differences between genders in terms of anterior and posterior vertebral body height from C3 to C7 level. Moreover, significant differences between genders in terms of anterior and posterior intervertebral height from C3-4 to C7-T1 level (except C6-7 intervertebral anterior height) were found. &#x0D; Conclusion: We would like to stress that the cervical region is a clinically important structure because of its location, surgical importance, its exposure to a large number of injuries, Gender plays the most important role in spinal canal morphometry, following vertebral

Increased Expression of Inflammatory Cytokines and Discogenic Neck Pain.

Although neck pain has become a serious economic and social problem worldwide, the etiology remains poorly understood. The aim of current study is to explore the possible pathogenesis of discogenic neck pain by analyzing the relationship between inflammatory cytokines and discogenic neck pain and provide a valuable reference for the prevention and treatment of discogenic neck pain. A total of 111 cervical disc samples were collected between October 1, 2021, and October 1, 2022: 38 samples from the discogenic neck pain group, 41 samples from the symptomatic control group, and 32 samples from the normal control group. The concentration of nitric oxide (NO), interleukin (IL)-1, interleukin (IL)-6, and tumor necrosis factor alpha (TNF-α) was determined using the enzyme-linked immunosorbent assay in each sample, and the degeneration degree of the target discs were evaluated using T2-weighted sagittal magnetic resonance imaging (MRI) according to the Miyazaki disc degeneration grading system. Whether the differences among the three groups were statistically significant was tested using one-way analysis of variance and an unpaired t-test, respectively. The differences of the baseline characteristics were not statistically significant between the discogenic neck pain group and the symptomatic control group (p > 0.05). The expression of inflammatory cytokines in disc samples from the discogenic neck pain group (NO: 9.89 ± 1.75, IL-1β: 10.74 ± 1.92, IL-6:31.65 ± 2.46, and TNF-α: 5.96 ± 1.91) was increased in comparison with the disc samples from both the symptomatic control group (NO: 7.15 ± 2.78, IL-1β: 8.03 ± 1.87, IL-6: 25.79 ± 2.12, and TNF-α: 4.18 ± 2.87) and the normal control group (NO: 6.11 ± 1.37, IL-1β: 5.84 ± 2.25, IL-6: 20.65 ± 1.26, and TNF-α: 2.05 ± 0.58). The differences were statistically significant (p < 0.001). Further, there were no statistical differences in the degree of degeneration between discogenic neck pain group and symptomatic control group. The increased expression of inflammatory cytokines in diseased cervical intervertebral discs might play a key role in the pathogenesis of discogenic neck pain. Although inflammation is involved in intervertebral disc degeneration, there is no linear positive correlation between the concentration of inflammatory cytokines and the degree of disc degeneration.

Possible case of prefixed brachial plexus in a dog with a caudal cervical intervertebral disc extrusion

AbstractA 5‐year‐old, entire, male dachshund was referred with a 7‐day history of non‐ambulatory paraparesis. The neurological examination was most consistent with a T3–L3 myelopathy. Magnetic resonance imaging and computed tomography studies of the cervical, cervicothoracic and thoracolumbar regions revealed a C7–T1 intervertebral disc extrusion causing moderate spinal cord compression. Based on the clinical presentation and imaging findings, a presumptive diagnosis of intervertebral disc extrusion in a dog affected by suspected prefixed brachial plexus was made. The dog underwent a ventral slot decompressive surgery, and its neurological conditions improved shortly after. The discrepancy between neuroanatomical localisation and location of an intervertebral disc extrusion may represent a possible instance of prefixed brachial plexus. To the authors’ best knowledge, prefixed brachial plexus has not been reported in dogs to date.

The Impact of Cervical Degeneration and Sagittal Balance on Retro-Odontoid Soft-Tissue Thickness

ObjectiveTo investigate whether retro-odontoid soft-tissue thickness (ROSTT) is associated with cervical degeneration, cervical spine mobility, and sagittal balance of cervical spine. MethodsThe data of 151 patients who presented at our hospital with cervical spondylosis were reviewed. The ROSTT was measured using T1-weighted sagittal cervical MRI fundings. The assessment of the degree of cervical intervertebral disc degeneration (IVDD) was conducted using sagittal T2-weighted imaging. The T1 slope (T1S), C1–C2 angle, C2−C7 angle, C1−C7 sagittal vertical axis (SVA) and C2−C7 SVA were measured. The range of motion (ROM) was assessed by measuring the flexion-extension radiographs. According to the ROSTT, those measuring less than 3mm were classified as normal group and those measuring larger than 3mm were classified as thickened group. ResultsThe thickened group had larger cervical IVDD grade, age, C2−C7 angle, and T1S compared to the normal group (all P<0.05). Additionally, the C0−2 angle was significantly smaller in the thickened group than in the normal group (P<0.05). ROSTT showed a negative correlation with C0−C2 angle (r=-0.181, P<0.05), but positive correlations with both C2−C7 angle (r=0.255, P<0.05) and T1S (r=0.240, P<0.05). Furthermore, ROSTT was positively correlated with age (r=0277, P<0.05) and cervical IVDD grade (Spearman, r=0.299, p<0.05). ConclusionsCervical sagittal balance and cervical degeneration have a significant impact on ROSTT. Patients with a higher T1S and severe cervical degeneration are more likely to result in greater ROSTT.

The Anatomical Relationship Between the Cervical Nerve Roots, Intervertebral Discs and Bony Cervical Landmark for Posterior Endoscopic Cervical Foraminotomy and Discectomy: A Cadaveric Study.

Cadaveric anatomical studies. This study aims to investigate the anatomical relationship between bony landmark "V point", dural sac, nerve roots, and intervertebral disc for improving operative outcomes and decreasing post-operative complications in posterior endoscopic cervical foraminotomy or discectomy (PECF or PECD). 10 soft adult cadavers were studied. We measured the distance of the V point to the lateral margin of dural sac, V point to the inferior border of intervertebral disc, and the inferior border of cervical nerve root to the inferior border of intervertebral disc. Then we calculated the mean of distance from V point to the inferior border of cervical nerve root. The mean distance from the V point to the lateral margin of dural sac from C3/4 to C7/T1 ranged from 3.1 ± 1.38mm to 3.37 ± 1.46mm. The mean distances from V point to the inferior border of intervertebral disc from C3/4 to C7/T1 were .19 ± 1.16mm at C3/4, .45 ± 1.23mm at C4/5, .43 ± 1.01 at C5/6, -.43 ± 1.86mm at C6/7 and -1.5 ± 1.2mm at C7/T1. The mean distance between V point and the inferior border of cervical nerve root from C3/4 to C7/T1 showed all positive value, ranging from .06 ± 1.18mm to 4.45 ± 2.57mm, increasing caudally. In performing PECF or PECD, a 3-4mm radius of bone removal should be enough for exposure and neural decompression at C3/4 to C5/6. At C6/7 and C7/T1 a more extensive bone cut of more than 4mm is recommended, especially in cranial direction.

Role of diffusion tensor imaging in stenotic and non-stenotic spinal canal

Background and purposeCervical Spondylotic Myelopathy (CSM) is a gradually escalating spinal cord disturbance set in motion by the degenerative narrowing of the vertebral canal. Routine MRI may fail to detect the subtle early alterations of the cord. MRI Diffusion Tensor Imaging (DTI) possesses the potential to detect these changes. This study intends to estimate the potential of the DTI technique in non-stenotic & stenotic spinal canals in individuals affected with CSM. MethodologySixty-four subjects who met the requirements of the inclusion criteria were incorporated into the investigation. All subjects underwent routine MRI sequences in addition to DTI of the cervical spine region. Scalars such as Fractional Anisotropy (FA), besides Apparent Diffusion Coefficient (ADC), were computed at each cervical intervertebral fibrocartilaginous disc level for all subjects. DTI fiber tractography was then performed to qualitatively assess the microstructural integrity of the tracts. ResultsA noteworthy difference (p<0.05) was seen in the FA parameter and ADC parameter values between the stenotic and non-stenotic groups, with the non-stenotic group having a higher mean FA and a lower ADC than the stenotic group (at the level of stenosis). A significant difference in age was seen between both groups, with most of the patients in the stenotic group belonging to 40 years and above. Tractography helped in demonstrating the morphology of the fiber tracts. ConclusionDTI parameters, namely FA and ADC, are sensitive to damage to the white matter and can be used to detect microstructural changes in the cord. However, standardization of the protocol is necessary when imaging the spinal canal.

Percutaneous Endoscopic Posterior Lateral Approach for the Treatment of Central Cervical Disc Herniation

To design percutaneous endoscopic surgery via a posterolateral approach for the treatment of central cervical disc herniation. From October 2019 to October 2020, 12 consecutive patients with central cervical disc herniation underwent percutaneous endoscopic posterior lateral cervical surgery. The imaging examination (dynamic X-ray, computed tomography, and magnetic resonance imaging of the cervical spine) was conducted after the operation. Visual analog scale score and the modified Japanese Orthopaedic Association score was performed before and after the operation. Twelve patients (6 men and 6 women; mean age 52.08±9.3years) were included, and the average operation time was 105.00±10.55minutes. Postoperative computed tomography and magnetic resonance imaging results showed that the treatment segment of all patients was prominent, the cervical intervertebral disc was completely removed, the cervical spinal cord was fully decompressed, and there were no cases of infection, cerebrospinal fluid leakage or neurological complications. The average follow-up time after the operation was 22.83±3.13months. One year after the operation, there was no cervical instability in the X-ray examination of cervical flexion and extension position. Preoperative visual analog scale score and the modified Japanese Orthopaedic Association score were significantly improved at the last follow-up. Percutaneous endoscopic posterior lateral cervical discectomy provides a new surgical method for the endoscopic treatment of central cervical disc herniation. This treatment has a better surgical field and easier operation, which can remove the protruding cervical disc under the endoscope and make sure that the cervical spinal cord is fully decompressed. The clinical effect is satisfactory. A small amount of pedicle resection will not cause cervical instability.

Video telescope operating monitor-assisted surgery is equivalent to conventional surgery in treatment of cervical intervertebral disc herniation in dogs.

To compare the use of the video telescope operating monitor (VITOM) and use of a conventional unassisted surgical method for treatment of cervical intervertebral disc herniation in dogs. 39 dogs with cervical intervertebral disc disease. Prospective study. Dogs were prospectively nonrandomly assigned to either the VITOM (n = 19) or conventional surgery (20) group depending on VITOM system availability. Signalment and preoperative neurologic status were recorded for all dogs. Preoperative and postoperative CT myelography was performed to compare intervertebral space location, spinal cord dimensions at the decompression level, ventral slot dimensions, and residual disc material. Surgical complications and postoperative neurologic outcomes were recorded. Data were compared between the 2 groups using fixed-effects or mixed-effects models to consider double reading of CT myelography images. No significant differences were noted between the 2 groups regarding the decompression ratio (P = .85), vertebral length body ratio (P = .13), ventral slot width ratio (P = .39), residual disc material (P = .30), and sinus bleeding (P = .12). No significant differences were found between the 2 groups regarding postoperative neurologic grade (P = .17). VITOM-assisted ventral slot decompression is equivalent to conventional surgery in treatment of cervical intervertebral disc herniation in dogs. The use of VITOM remains a good alternative to the conventional surgical method.

Vertebral fixation does not affect recovery or recurrence of cervical intervertebral disc herniation in small dogs (< 15 kg).

To compare the prognosis of small dogs with cervical intervertebral disc herniation (C-IVDH) when treated with ventral slot decompression (VSD) alone or with concomitant vertebral fixation (VF). Small dogs (n = 303) weighing < 15 kg diagnosed with C-IVDH and treated with VSD. We recorded signalment, cervical myelopathy grade, surgical site, use of VF, degree of adjacent disc degeneration, recovery, recurrence, recurrence site, and postoperative course, including the time elapsed from recovery to recurrence. We examined factors associated with recovery and recurrence during the 30-month postoperative period using multivariate logistic regression analysis. VF did not affect recovery (P = .79). However, nonchondrodystrophic breeds had poorer recovery (OR, 5.89; P = .023) than chondrodystrophic breeds, and a higher preoperative cervical myelopathy grade (grade 3 or 4) was associated with poorer recovery (OR, 7.09 or 3.46, respectively; P = .019 or .042, respectively), compared with grade 1. VF did not affect recurrence (P = .79); however, increasing age was associated with recurrence (OR, 1.79; P = .001). In small dogs weighing < 15 kg, there was no difference in postoperative recovery and recurrence rates after VSD with or without concomitant VF. Therefore, in small dogs with C-IVDH, even if the slot volume is increased to remove sufficient disc material during VSD, a good prognosis can be achieved with or without VF.

A Predictive Model for the Risk of Recurrence of Cervical Spondylotic Radiculopathy After Surgery.

This study aimed to analyze the risk factors affecting the recurrence of cervical spondylotic radiculopathy after surgery, construct a nomogram predictive model, and validate the model's predictive performance using a calibration plot. In this study, 304 cervical spondylotic radiculopathy patients who underwent computed tomography (CT)-guided radiofrequency ablation (RFA) of cervical intervertebral discs or low-temperature plasma RFA for cervical radiculopathy were enrolled at the Pain Department of Jiaxing College Affiliated Hospital from January 2019 to March 2022. The patients were randomly divided into training (n = 213) and testing (n = 91) groups in a 7:3 ratio. Lasso regression analysis was used to screen for independent predictors of recurrence 1 year after surgery. A nomogram predictive model was established based on the selected factors using multiple logistic regression analysis. One year after surgery, 250 of the 304 cervical spondylotic radiculopathy patients did not have recurrences, while 54 had recurrences. Lasso regression combined with multiple logistic regression analysis revealed that duration, numbness, and the Numeric Rating Scale (NRS) were significant predictors of recurrence 1 year after surgery (P < 0.05). A nomogram predictive model was established using these variables. The area under the curve (AUC) of the nomogram predictive model for predicting recurrence in the training group was 0.918 [95% confidence interval (CI) 0.866-0.970], and the AUC in the testing group was 0.892 (95% CI 0.806-0.978). The Hosmer-Lemeshow goodness-of-fit test exhibited a good model fit (P > 0.05). Decision curve analysis (DCA) indicated that the nomogram predictive model had a higher net benefit for predicting the risk of postoperative recurrence in cervical radiculopathy patients when the threshold probability was between 0 and 0.603. This study successfully developed and validated a high-precision nomogram prediction model (predictive variables include duration, numbness, and NRS) for predicting the risk of postoperative recurrence in cervical radiculopathy patients. The model can help improve the early identification of high-risk patients and screening for postoperative recurrence.

A Systematic Review for Cervical Intervertebral Disc Arthroplasty versus Anterior Cervical Discectomy and Fusion in the Treatment of Cervical Degenerative Spine Disorders

Background Cervical disc arthroplasty (CDA) is an increasingly accepted procedure for the treatment of symptomatic cervical degenerative disc disease. Multiple Level I evidence clinical trials have established cervical TDR to be a safe and effective procedure in the short-term. Aim of the Study is to provide a long-term assessment of cervical disc arthroplasty (CDA) versus anterior discectomy and fusion (ACDF) for the treatment of one- and two-level disc disease. Patients and Methods Systematic review of published English literature, the study was done from July 2014 to June 2020 and the study setting was Internet search through MEDLINE and Cochrane Collaboration Library. Results Our study provided further evidence that CDA is superior in achieving long-term clinical outcomes such as overall success, NDI success and neurological success, VAS neck pain and arm pain, symptomatic ASD, total secondary surgery, and secondary surgery at the index level and at the adjacent level. Conclusion However, no clear benefit could be identified in regard to NDI score, total reported AE, serious AE, device/surgery- related AE, and radiological superior and inferior ASD. Welldesigned worldwide RCT with long-term follow up are still necessary for further evaluation in the future.

Mechanical properties of an elastically deformable cervical spine implant

Anterior cervical surgery is widely accepted and time-tested surgical procedure for treating cervical radiculopathy and myelopathy. However, there is concern about the high adjacent segment degeneration rate and implant subsidence after the surgery using the traditional polyetheretherketone cage. Thus, we creatively designed a polyurethane cervical implant that can continuous load-sharing through elastic deformation and decrease postoperative stress concentration at adjacent segments. In this study, the design rationality and safety of this novel implant was evaluated based on several mechanical parameters including compression test, creeping test, push-out test and subsidence test. The results showed that the novel cervical implant remained intact under the compressive axial load of 8000 N and continues to maintained the elastic deformation phase. The minimum push-out load of the implant was 181.17 N, which was significantly higher than the maximum compressive shear load of 20 N experienced by a normal human cervical intervertebral disc. Besides, the creep recovery behaviour of the implant closely resembled what has been reported for natural intervertebral discs and clinically applied cervical devices in literature. Under the load of simulating daily activities of the cervical spine, the implant longitudinal displacement was only 0.54 mm. In conclusion, this study showed that the current design of the elastically deformable implant was reasonable and stable to fulfil the mechanical requirements of a cervical prosthesis under physiological loads. After a more comprehensive understanding of bone formation and stress distribution after implantation, this cervical implant is promising to be applied to certain patients in clinical practice.

The Difference Between the Effects of the McKenzie Neck Exercise and Contract-Relax Stretching on Neck Function of Onion Peelers with Myofascial Pain Syndrome

Many jobs have health risks caused by unergonomic posture while working for a long time. One of the disorders that often occurs is myofascial pain syndrome. If ignored, there will be a disruption in neck function. Contract-relax stretching can reduce the pain and spasm in neck muscles, while the McKenzie neck exercise can restore the cervical intervertebral disc to its normal position and reduce neck disability. This research aimed to determine the difference in the effect of contract-relax stretching and the McKenzie neck exercise on the neck‘s function in onion peelers with myofascial pain syndrome. The study was quasi-experimental with two groups: pre-test and post-test design. The population was onion peelers at CV. Anita Jaya Sukses, Sidoarjo. The sample was 18 respondents who met the inclusion criteria. Data weres analyzed using the Independent Sample T-test. Based on the test, contract-relax stretching and McKenzie neck exercise obtained a significant value of 0.011(p&lt; 0.05), so H0 is rejected and H1 is accepted. The study concluded that there was a difference in the effect of contract-relax stretching and McKenzie neck exercise on neck function in onion peelers with myofascial pain syndrome.&#x0D; Keywords: Contract-relax stretching, McKenzie neck exercise, myofascial pain syndrome

Evaluation of hemodynamics in vertebral arteries in case of herniated cervical intervertebral discs using functional tests

Background. Degenerative changes of the vertebral-motor segment occupy an important place among the causes of cervicogenic headache, neck pain with radiation to the shoulder and arm, noise in the head, dizziness. The same symptoms are often found in vertebral artery syndrome, which is a set of disorders of vertebral-basilar dynamics. Dopplerography makes it possible to obtain quantitative parameters of blood flow in the vertebral arteries, thereby assessing the level of pathological changes in blood flow.&#x0D; Purpose. Dopplerographic assessment of blood flow parameters in vertebral arteries in patients with herniated cervical intervertebral discs using functional tests.&#x0D; Materials and methods. An analysis of the results of dopplerography of the vertebral arteries in 42 young patients with herniated cervical intervertebral discs was carried out. Peak systolic velocity (Vs), end-diastolic velocity (Vd), indices of peripheral resistance (RI) and pulsatility (PI), minute volume of blood flow (HOK – Vvol) in the second segment of the VA at the C2-C3 level were determined at functional prob.&#x0D; Results and discussion. With a left-sided hernia, the value of Vs in the left VA during contralateral head rotation was 34.1 ± 2.9 cm/s, RI – 0.71 ± 0.03, PI – 1.04 ± 0.06, HOC – 85 ± 9 ml/min, and in the comparison group – 45.3 ± 3.8 cm/s, 0.59 ± 0.02, 0.85 ± 0.04, 118±13 ml/min, respectively. In patients with a right-sided hernia, Vs in the right VA during contralateral head rotation was 32.6 ± 3.2 cm/s, RI – 0.72 ± 0.03, PI – 1.03 ± 0.06, COC – 83 ± 8 ml/min, and in the comparison group – 44.8 ± 4.1 cm/s, 0.60 ± 0.02, 0.87 ± 0.04, 117 ± 12 ml/min, respectively. The difference between Doppler blood flow parameters obtained during contralateral head rotation in patients with disc herniation and the comparison group (persons without disc herniation) was significant (P &lt; 0.05).&#x0D; Conclusion.Hemodynamically significant disruption of blood flow in the vertebral artery occurs when the paramedian and posterolateral hernia is localized on the side of the same name during head rotation to the opposite side. These violations consist in a significant decrease in systolic speed and minute volume of blood flow, in an increase in indices of resistance and pulsatility compared to persons without disc herniation.