Cervical Osteoarthritis Research Articles

The Horse & Rider: A Dynamic 3D Model for Studying the Role of Chronic Postural Asymmetries in Degenerative Osteoarthritis

Chronic lamenesses in horses are often managed but not effectively treated. We hypothesize that (1) a causal relationship exists between the forces created by aberrant biomechanical positions and movements, including those caused by the rider, and degenerative joint diseases; and (2) adjusting the aberrant biomechanics will be therapeutic. To test our hypotheses, we constructed a dynamic 3D computer model using equine CT data and human CT data to model full body positions of horses with riders that can then be related to sites of tissue damage in equine lamenesses. The bones of the horse and human were reconstructed from CT data using the 3D visualization and analysis software, Avizo®. The individual bones were then imported into Autodesk® Maya® for re‐positioning into their respective organism, creating a 3D human model and a 3D equine model. A 3D rig was developed for each model separately to allow for accurate positioning and animation for each. The ribbon spine technique was used for the neck and spine on both models for increased accuracy in positioning and movement with the ability to rotate and bend the spines and necks into natural positions. The rigging used for both the horse and human were adopted to be manipulated using controls for quicker and easier positioning. Once the two rigs were completed, they were imported into a single file. The human rig and its matching skeleton were scaled in reference to the equine rig and its matching skeleton; and the human rigged model was positioned atop the rigged equine model to simulate a rider on its horse. The combined model was used to analyze the chronic postural abnormalities of a horse with cervical osteoarthritis using information from photographs of the horse being ridden at the trot. Findings included a markedly asymmetric stride, a dorsiflexed lower limb that indicates overloading of the front legs, and over‐flexion of the neck that correlated with sites of compressive degeneration in the cervical spine. Our long term goal is to expand the models for biomechanical analysis and to further develop the rigging protocol in order to expand its usefulness for both animal and human studies.Support or Funding InformationLouisiana State University School of Veterinary Medicine Charles V. Cusimano Equine Health Studies Program

Occupational pathology of soft tissues of the shoulder joint and difficulties of examination

A predominant development tendinosis the long head of m. biceps. The difficulties of examination of the connection of the disease with the profession are due to hyperdiagnosis of cervical osteochondrosis and osteoarthritis of the shoulder joints, ignoring the pathology of soft tissues of the shoulder area.

Osteoarthritis in the Middle-Aged and Elderly in China: Prevalence and Influencing Factors.

Background: Osteoarthritis is a common joint disease, with the acceleration of the aging process in China, it has troubled the middle-aged and elderly. There have been some epidemiological studies of osteoarthritis conducted in one single site, and most of them were on knee osteoarthritis. The results varied greatly between different surveys. There was still a lack of large-scale and multicenter epidemiological studies of osteoarthritis. This paper aimed to estimate the overall prevalence of lumbar osteoarthritis, cervical osteoarthritis, hand osteoarthritis, knee osteoarthritis, and hip osteoarthritis in the middle-aged and elderly in China by summarizing the existing publications. Methods: We comprehensively searched publications on 1 January 2019 in PubMed, Web of Science, Embase, Cochrane Library, CBM, CNNI, VIP, and Wan Fang. Epidemiological publications on osteoarthritis in the middle-aged and elderly Chinese published from 2000 to 2018 were summarized and analyzed by means of systematic review and meta-analysis. Data of prevalence of osteoarthritis in five joints were extracted from the included publications. The Hoy 2012 tool was used to assess the risk of bias of included studies. Results: After performing a systematic search in eight databases and manually searching, 3058 articles were obtained, and 21 articles were included in the meta-analysis. Lumbar osteoarthritis was the most prevalent with a prevalence of 25.03% (95% CI: 0.1444–0.3562). The prevalence of knee osteoarthritis followed, which was 21.51% (95% CI: 0.1873–0.2429). The prevalence of cervical osteoarthritis was 20.46% (95% CI: 0.1244–0.2849). The prevalence of hand osteoarthritis was 8.99% (95% CI: 0.0435–0.1364). The prevalence of hip osteoarthritis was not pooled due to its lack of data. Higher prevalence of knee, hand, lumbar, and cervical osteoarthritis was seen in the female group and southern regions. The prevalence of knee and hand osteoarthritis increased with age. The prevalence of lumbar and cervical osteoarthritis increased with age. There was also a trend that the prevalence increased with age before 70 years old and slightly decreased in the oldest ages. Conclusions: The lumbar joint was the joint most prevalently affected by osteoarthritis, followed by the prevalence of knee, cervical, hand, and hip joint osteoarthritis. Women, the southern population, and the older population are more susceptible to osteoarthritis. The paucity of epidemiology data of osteoarthritis in China appeals for more population-based surveys being conducted in the future. Based on the relatively high prevalence of osteoarthritis obtained from this review, self-management and community-based management should be considered, which can provide experience from the management of hypertensions and diabetes.

Observation of Schlemm\u2019s canal and transluminal trabeculotomy using an ophthalmic endoscope: a case report

BackgroundGonioscopy-assisted transluminal trabeculectomy is a novel and useful technique for ab interno trabeculotomy. However, gonioscopy-assisted transluminal trabeculectomy is difficult to perform in patients with corneal opacity or in patients with sequelae of cerebral infarction and cervical osteoarthritis with severe limitation of spinal mobility. This is because observing Schlemm’s canal during surgery using gonioscopy is difficult. In this report, we introduce a new and beneficial surgical technique of transluminal trabeculotomy for these patients, using an ophthalmic endoscope for cases in which normal gonioscopy-assisted transluminal trabeculectomy is difficult.Case presentationOur patient was a 65-year-old Japanese man with cervical osteoarthritis with severe limitation of spinal mobility who showed primary open-angle glaucoma of the right eye. He had limited conversion of his head during surgery because of complications. Therefore, we performed transluminal trabeculotomy using an ophthalmic endoscope. Finally, ab interno trabeculotomy of 200 degrees was achieved by this method, and an average reduction in ocular pressure of 60% from baseline was achieved after surgery, with no major complications.ConclusionsThis surgical technique may be useful as an alternative method for normal gonioscopy-assisted transluminal trabeculectomy in difficult cases.

Myofascial Pain Secondary to Duane Syndrome: A Case Study

Introduction: Myofascial pain in the trapezius, rhomboids, levator scapulae and sternocleidomastoid is often linked to cervical and thoracic disc degeneration and facet osteoarthritis as well as postural imbalances and muscle deconditioning. Case Report: We present the case of a 37-year-old female with Duane Syndrome who presented with chronic neck and mid-back pain. We tried a multimodal approach to myofascial pain management, including physical therapy, nortriptyline 10 mg to address potential central sensitization as well as neuropathic pain, and trigger point injections. Ultimately, the patient underwent ocular surgery, after which her myofascial pain improved. Our other treatment interventions became significantly more effective after the surgery. Conclusion: To our knowledge, this is the first case in the literature of extraocular muscle disorders being associated with myofascial pain. It is also the first case of myofascial pain successfully treated by corrective oculoplastic surgery. Extraocular disorders can lead to overuse or repetitive trauma to the trapezius, rhomboids, levator scapulae, sternocleidomastoid and other muscles of the neck and trunk as the patient uses compensatory motions to ease their visual difficulties. This overuse can then lead to myofascial pain and trigger point formation.

CORRELATION BETWEEN ARTHRITIC CHANGES IN CERVICAL VERTEBRAE AND TMJ

Introduction Osteoarthritis (OA) is one of the most common pathologic conditions affecting the cervical spine and other joints, including the temporomandibular joint (TMJ). There are various theories regarding the etiology of vertebral and joint degeneration, the most common being physiologic degeneration with increasing age. Typically, degeneration is restricted to a specific joint, but often when there is a transfer of load, there could be degenerative changes associated with joints in the vicinity as a result of a compensatory load transfer mechanism. Therefore, there is a possible correlation between arthritic changes in the cervical vertebrae and those in the TMJ. Objective The objective of this study was to retrospectively evaluate cone beam computed tomography (CBCT) scans to study the relationship between the presence/absence of degenerative changes in the cervical vertebrae and its relationship to arthritic changes in the TMJ. Materials and Methods A total of 150 CBCT scans from the archives of the Department of Oral and Maxillofacial Radiology at the School of Dental Medicine, University of Connecticut, were evaluated for this study. Inclusion criteria were scans that had the TMJ bilaterally and at least the cervical vertebrae C1 to C4 in the field of view. The scans were scored for the presence or absence osteoarthritis in both TMJs and their severity by using the Weishaupt/Pathria grading classification. Results Of the 150 scans analyzed, 72% showed a correlation between the presence/absence of both cervical spine and TMJ osteoarthritis, whereas the remaining 28% did not show any association or correlation. Of the 72%, only 0.4% showed a linear relationship between osteoarthritis of both joints based on the degree of severity. Conclusions A large percentage of the scans showed a correlation between the presence/absence cervical spine osteoarthritis and TMJ osteoarthritis, but no relationship based on their degree of their severity. A larger sample size must be evaluated, as the next logical step, to further understand this relationship.

Efficacy and safety of the pulsed electromagnetic field in osteoarthritis: a meta-analysis

ObjectiveTo investigate the efficacy and safety of the pulsed electromagnetic field (PEMF) therapy in treating osteoarthritis (OA).DesignMeta-analysis.Data sourcesPubMed, Embase, the Cochrane Library and Web of Science were searched through 13...

Prospective randomized controlled trial in the treatment of lateral epicondylitis with a new dynamic wrist orthosis

BackgroundIn the treatment of lateral epicondylitis (LE), the role of a new dynamic wrist orthosis is unclear.Patients and methodsPatients suffering from a LE longer than 3 months were multicentrically and prospectively randomized into a physiotherapeutic group (PT group) and in a physiotherapy group plus wrist orthosis (PT + O group). Physiotherapy consisted of daily eccentric strengthening exercises under initial professional supervision. Inclusion criteria were a Placzek score greater than 4. Exclusion criteria were previous surgery, rheumatic arthritis, elbow instability, radicular symptoms, higher-grade extensor tendon rupture, or cervical osteoarthritis. The clinical evaluation was performed after 12 weeks and 12 months. The Patient-Rated Tennis Elbow Evaluation (PRTEE) scale, Placzek Score, the pain rating (VAS), range of motion and the Subjective Elbow Score were evaluated.ResultsOf the initially 61 patients, 31 were followed up after 12 weeks and 22 after 12 months. Twenty-nine patients (43%) were male, the mean age was 46, and 44 patients (66%) had the right elbow involved. At 12 weeks, there was a pain reduction on the VAS in both groups (PT + O: 6.5–3.7 [p = .001]; PT: 4.7–4.1 [p = .468]), albeit it was only significant for the PT + O group. At 12 months, reduction was significant in both groups (PT + O: 1.1 [p = .000]; PT: 1.3 [p = .000]). The painless maximum hand strength in kg improved in both groups significant after 3 and 12 months. The Placzek score was reduced from 8.25 to 3.5 [p = .001] after 12 weeks for the PT + O group and from 8.1 to 3.8 [p = .000] in the PT group, as well as after 12 months in the PT + O group to 0 [p = .000] and in the PT group to 2.0 [p = .000]. The PRTEE improved in both groups after 12 weeks (PT + O: 52.8––31.3 [p = .002]; PT: 48.6–37.6 [p = .185]) and 12 months (PT + O: 16.15 [p = .000]; PT: 16.6 [p = .000]), although the reduction at 12 weeks was not significant for the PT group.ConclusionThe elbow orthosis appears to accelerate the healing process with respect to the PRTEE and pain on the VAS (12 weeks follow-up), although there is an adjustment after 12 months in both groups and a significant improvement of symptoms is achieved in all endpoints.

The Disappearing Lamellae: Implications of New Findings in the Family Equidae Suggest the Loss of Nuchal Ligament Lamellae on C6 and C7 Occurred After Domestication

Conflicting data predominantly describes the equine nuchal ligament lamellae (NLL) attachments as C2–C6 or C2–C7; however, preliminary evidence suggests C2–C5. This study aimed to identify morphological variations in the attachments of the NLL in four species of the family equidae and determine if the variations were species or breed linked. Cadaveric examination evaluated 98 equids; Equusasinus (n = 2), Equus ferus caballus (n = 93), Equus przewalskii (n = 2), and Equus quagga boehmi (n = 1). Twenty breeds of E. f. caballus were included according to breed type—modern horse (n = 81), ancient type (n = 10), primitive (n = 4). Of the 98 equids, observations were divided into three categories according to the NLL attachments: C2–C5, C2–C6, and C2–C7; in category C2–C7, E. f. caballus (n = 3/93), modern horse 0 of 81, ancient 1 of 8, primitive 2 of 4; in category C2–C6, modern horse 2 of 81; in category C2–C5, modern horse 79 of 81, ancient type 7 of 8, primitive 2 of 4. Equus asinus, E. przewalskii, and E. q. boehmi all expressed category C2–C7. In total, 88 of 98 expressed category C2–C5; 2 of 98 category C2–C6; and 8 of 98 category C2–C7. These findings suggest that category C2–C5 provides sufficient evidence to suggest a normal occurrence. The high incidence of an absent NLL on C6 and C7 may be considered a contributing factor in caudal cervical osteoarthritis. Furthermore, category C2–C7 still exists in an ancient and primitive breed closely related to the tarpan, implying the NLL may have been attached from C2 to C7 in prehistoric horse before domestication. This hypothesis is supported by the findings of E. asinus, E. przewalskii, and E. q. boehmi, displaying attachments from C2 to C7.

PNF and manual therapy treatment results of patients with cervical spine osteoarthritis.

PURPOSE: The aim of this study was to evaluate the effectiveness of PNF and manual therapy methods in the treatment of patients with cervical spine osteoarthritis, especially their efficacy in reducing pain and improving functionality in everyday life. Long-term results were also compared in order to determine which method of treatment is more effective.SUBJECTS AND METHODS: Eighty randomly selected females aged 45–65 were included in the study. They were randomly divided into two groups of 40 persons. One group received PNF treatment and the other received manual therapy (MAN.T). To evaluate functional capabilities, the Functional Rating Index was used. To evaluate changes in pain, a shortened version of the McGill Questionnaire was used.RESULT: The PNF group achieved a greater reduction in pain than the MAN.T group. The PNF group showed a greater improvement in performing daily activities such as sleeping, personal care, travelling, work, recreation, lifting, walking and standing as well as decreased intensity and frequency of pain compared to the MAN.T group.CONCLUSION: The PNF method proved to be more effective in both short (after two weeks) and long (after three months) term.

CORTICOSTERIODS INDUCED ECCHYMOSIS

Corticosteroids are the steroid hormones which are mainly used in the treatment of various diseases like rheumatoid arthritis, osteoarthritis, rheumatic fever, gout, allergic reactions, renal diseases and haematological diseases. Prolonged use of corticosteroids causes a number of undesirable effects. Major adverse drug reaction (ADR’s) includes ulcers/gastrointestinal bleeding, osteoporosis, increased risk of heart diseases and decreased in bone density. Here we report a case of male patient of 72years old who was confirmed with cervical osteoarthritis and using oral corticosteroid (OCS) (methylprednisolone) since 6 y. While the patient was on therapy ecchymosis was noticed. The relation between suspected drug and ADR was established by performing ADR assessment scale, whereas both de-challenge and re-challenge was done, and ADR assessment scales like Naranjo’s scale, WHO UMC scales showed probable ADR, it can be managed by stopping the drug or using alternative days. Close monitoring of blood cortisol levels in a patient using oral corticosteroids (OCS) should be done.

Static or dynamic low-frequency magnetic field? A review of literature

The therapeutic application of magnetic fi elds has experienced signifi cant growth in recent years. A small number of contraindications, as well as the lack of side effects makes both permanent magnets and alternating magnetic fi elds frequently used in physical therapy practice. In a signifi cant number of clinical studies the effi cacy of this physical factor as both an independent method, as well as supporting treatment programs has been confi rmed. In the last few years, a lot of emphasis is put on the fact that all therapeutic methods should have a scientifi c basis and their usage should meet the evidence based medicine criteria (EBM). Therefore, this work will focus on comparison of the use of permanent magnets and alternating low-frequency magnetic fi eld on the basis of the available literature, including mainly, a randomized double-blind trial. Analysis of the available literature on permanent magnet usage has shown clinical effi cacy in many diseases, however, placebo-controlled studies confi rm mainly the analgesic effect in patients after liposuction surgery, with diabetic neuropathy and with chronic pelvic pain. The use of the alternating low-frequency magnetic fi eld also leaves many questions to which scientists have still not found the answer. Randomized double-blind trial proved its therapeutic effi cacy in patients after knee arthroscopy, fractures and delayed bone unions, knee and cervical spine osteoarthritis as well as in case of leg ulceration. Alternating magnetic fi eld application has a wider therapeutic range in comparison to permanent magnets and its effectiveness is much better documented, both in clinical studies as well as randomized double-blind trials. Cite this article as: Głąb G., Dudek J., Klimek K., Skalska-Dulińska B., Chrabota U., Chojak-Fijałka K., Ridan T., Glodzik J. Static or dynamic low-frequency magnetic field? A review of literature. Med Rehabil 2016; 20(2): 31-35.

PS 03-15] A STUDY ON THE PREVALENCE OF PATHOLOGIES OF THE CERVICAL SPINE IN PATIENTS WITH ESSENTIAL HYPERTENSION

Objective: Installation of the prevalence of osteochondrosis in the development of essential hypertension. Design and method: The diagnosis of hypertension was made based on the criteria recommended by the European (2003) and Russian (2004) societies of cardiology. The presence and severity dorsopathy on the background of osteochondrosis according to generally accepted clinical and radiological criteria. From the study were excluded patients with severe and malignant hypertension, severe cardiac insufficiency, myocardial infarction or stroke in the last 3 months. Results were examined 121 patients with essential hypertension. Results: It was found that in 81 (66.9 per cent) patients with essential hypertension, we observed changes in the spine. The authors analyzed the most frequent clinical and radiological symptoms of cervical degenerative disc disease with this combination of pathological processes. In the study of the cervical spine most commonly detected signs of uncovertebral arthrosis 9.09%(11 people), and also abnormal mobility in one or more intervertebral segments -6.6%(8 people), straightening of the lordosis, scoliosis, uneven decrease in height of intervertebral discs - 19 (15.7 percent), spondiloartrozis - 27,2% (33 people). Disc protrusion C6-C7–14 people (11.5 per cent). In most patients, is dominated by the degree of cervical osteoarthritis by Zekera. Conclusions: In the examined group of patients with essential hypertension in middle-aged and elderly people the frequency of concomitant dorsopathies (osteoarthritis) of the cervical spine was 66.9%, this figure indicates the possible relationship of these pathologies, and may help in the treatment of people with hypertension not amenable to medical therapy.

Effect of isolated and combined practice of Yoga and Ayurveda Therapy on pain among Cervical Osteoarthritis Patients

Cervical Osteoarthrities is one of the most common disorder of the cervical spine. It is caused by degenarative changes in the vertebral and intervertebral discs, that occur because of constant improper stress on the cervical spine due to abnormal posture, injury, aging, rheumatoid disease. The medical management options inclued use of analgesics for pain. However due to the adverse effects that they produce it has its own limitations. This study has been designed to evaluate the combined effect of Yoga Therapy and Ayurvedic Medications in Cervical Osteoarthritis. It was a Randomized single blind study conducted in 30 patients attending O.P.D. of S.H.E.S. A.M.C. College Kalaburagi, Karnataka and grouped into three. The first group of subjects received Yoga treatment, the second group received Ayurvedic treatment and the third group received both Yoga and Ayurvedic treatment for eight weeks. The result of the study showed that the combined group of Yoga and Ayurveda treatment (Group C) shows good response compaired to Ayurveda (Group-A) and Yoga (Group-B).

Spa therapy for elderly: a retrospective study of 239 older patients with osteoarthritis.

Very few studies tested the effectiveness of spa therapy in older patients with osteoarthritis. Therefore, we aimed to evaluate the short-term effects of spa therapy in patients aged 65years and older with generalized, knee, hip, and cervical and lumbar spine osteoarthritis. In an observational retrospective study design at the Medical Ecology and Hydroclimatology Department of Istanbul Medical Faculty, we analyzed the records of 239 patients aged over 65years with the diagnosis of all types of osteoarthritis who were prescribed a spa therapy course in some spa resorts in Turkey between 7 March 2002 and 31 December 2012. They travelled to a spa resort where they stayed at a thermal spa hotel and followed the usual therapy packages for 2weeks. Patients were assessed by an experienced physician within a week before the spa journey and within a week after the completion of the spa therapy. Compared with baseline in whole sample, statistically significant improvements were observed in pain (visual analog scale, VAS), patient and physician global assessments (VAS), Health Assessment Questionnaire disability index (HAQ-DI), Lequesne algofunctional index (LAFI) for knee, Western Ontario and McMaster Universities index (WOMAC), Waddell disability index (WDI), and Neck Pain and Disability Scale (NPAD). According to Outcome Measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) Set of Responder Criteria, responder rate were 63.8% (51/80) in generalized, 52% (13/25) in knee, 50% (2/4) in hip, 66.7% (8/12) in lumbar, and 100% (6/6) in cervical osteoarthritis subgroups. Spa therapy improved pain and physical functional status in older patients with osteoarthritis, especially generalized osteoarthritis and multiple joint osteoarthritis with involvement of knee. This improvement was clinically important in majority of the patients. To confirm the results of this preliminary study, there is a need of a randomized controlled clinical study comparing spa therapy with usual care in the elderly population with osteoarthritis.

Degenerative joint disease of the cervical spine across continents and millennia: do culture or geography matter?

Background: The study endeavoured to determine the presence of cervical spondylosis in the cervical vertebral bones and osteoarthritis in the facet joints of the cervical spine in three distinct populations.

Cervical vertebral trabecular bone mineral density in Great Danes with and without osseous-associated cervical spondylomyelopathy.

BackgroundGreat Danes (GDs) with osseous‐associated cervical spondylomyelopathy (CSM) have osteoarthritis (OA) of the cervical vertebrae. OA is often associated with increases in bone mineral density (BMD) in people and dogs.Hypothesis/ObjectivesTo compare the trabecular BMD of the cervical vertebrae between clinically normal (control) GDs and GDs with osseous‐associated CSM by using computed tomography (CT). We hypothesized that the vertebral trabecular BMD of CSM‐affected GDs would be higher than that of control GDs.AnimalsClient‐owned GDs: 12 controls, 10 CSM affected.MethodsProspective study. CT of the cervical vertebral column was obtained alongside a calibration phantom. By placing a circular region of interest at the articular process joints, vertebral body, pedicles, and within each rod of the calibration phantom, trabecular BMD was measured in Hounsfield units, which were converted to diphosphate equivalent densities. Trabecular BMD measurements were compared between CSM‐affected and control dogs, and between males and females within the control group.ResultsDifferences between CSM‐affected and control dogs were not significant for the articular processes (mean = −39; P = .37; 95% CI: −102 to 24), vertebral bodies (mean = −62; P = .08; 95% CI: −129 to 6), or pedicles (mean = −36; P = .51; 95% CI: −105 to 33). Differences between female and male were not significant.Conclusions and Clinical ImportanceThis study revealed no difference in BMD between control and CSM‐affected GDs. Based on our findings no association was detected between cervical OA and BMD in GDs with CSM.

Latero‐Oblique Radiography as a Diagnostic Tool for Equine Cervical Osteoarthritis

Reasons for performing studyEquine cervical osteoarthritis is a common disease known to contribute to both neck pain and cervical vertebral compressive myelopathy. There are no published studies demonstrating the usefulness of latero‐oblique radiography as a diagnostic tool for cervical osteoarthritis.ObjectivesTo determine the sensitivity, specificity and positive and negative predictive values of latero‐oblique radiography as a diagnostic tool for cervical articular process joint osteoarthritis.Study designProspective cadaver study.MethodsLatero‐oblique radiographs and CT images were collected, and post mortem examinations performed, on 27 cadaver necks from Thoroughbred‐type horses of various ages and sexes. Two equine clinicians independently reviewed each set of images for the presence of osteoarthritis. The authors, under the guidance of a veterinary pathologist, reviewed all articular process joints for bony changes indicative of osteoarthritis.ResultsThe prevalence of osteoarthritis identified on CT images was 57.9% (Assessor A) and 23% (Assessor B). The prevalence of lesions identified on post mortem examination was 25.6%. Latero‐oblique radiography showed a low sensitivity for identifying osteoarthritis when compared to both CT imaging (6.3–16.1%) and post mortem examination (2.2–4.4%). However, it showed a high specificity when compared to both CT imaging (92.1–97.8%) and post mortem examination (87.2–95.0%). The positive predictive value for identifying osteoarthritis was moderate (40.9–80.0%) when compared to CT imaging and poor (4.2–18.2%) when compared to post mortem examination. The negative predictive value was moderate when compared to both CT imaging (42.9–76.3%) and post mortem examination (78.0–79.8%).ConclusionsLatero‐oblique radiography has low sensitivity, but high specificity for the detection of cervical osteoarthritis when compared to both CT imaging and post mortem examination. Further investigation comparing the sensitivity, specificity and positive and negative predictive values of latero‐oblique radiography vs. laterolateral radiography would determine whether taking latero‐oblique radiographs, which can be more difficult to obtain and interpret, is necessary for the diagnosis of cervical osteoarthritis in practice.Ethical animal research: Ethical committee oversight not currently required by this congress: The study was performed on material obtained from an abattoir. Sources of funding: None. Competing interests: None.

Influência da manipulação osteopática na amplitude de rotação da coluna cervical em indivíduos com cervicalgia mecânica crônica

JUSTIFICATIVA E OBJETIVOS: A amplitude de movimento do pescoço pode ser reduzida pela presença de disfunções vertebrais e miofasciais, as quais podem ser tratadas pela manipulação osteopática por meio da técnica articulatória rítmica cervical. O objetivo deste estudo foi verificar se a manipulação osteopática, através da técnica articulatória rítmica gera aumento da amplitude de rotação cervical mensurada por fleximetria. MÉTODOS: A casuística foi constituída de 58 indivíduos de ambos os gêneros, com idade média de 36±6,5 anos, com cervicalgia mecânica crônica, que foram submetidos de maneira randomizada à fleximetria controle da rotação cervical, à manipulação osteopática, por meio da técnica articulatória rítmica, ao repouso de 5 minutos e à fleximetria estudo da rotação cervical. RESULTADOS: A comparação entre as médias das fleximetrias de rotação cervical através do teste t de Student para dados pareados, ao nível de significância de 0,05 (5%), mostrou que houve aumento significativo da rotação cervical em todos os casos (p<0,05) passando de 151,4º para 162,5º no arco total de movimento (aumento de 7,3%). CONCLUSÃO: Os resultados foram dentro do esperado, confirmando que a manipulação osteopática, através da técnica articulatória rítmica gerou aumento significativo da amplitude de rotação cervical em todos os casos, podendo servir de tratamento de doenças que se relacionam à redução da mobilidade vertebral, como cervicalgia e osteoartrite cervical.

Low Level Laser Therapy (LLLT) for Neck Pain: A Systematic Review and Meta-Regression.

Purpose:This systematic review update evaluated low level laser therapy (LLLT) for adults with neck pain.Methods:Computerized searches (root up to Feb 2012) included pain, function/disability, quality of life (QoL) and global perceived effect (GPE). GRADE, effect-sizes, heterogeneity and meta-regression were assessed.Results:Of 17 trials, 10 demonstrated high risk of bias. For chronic neck pain, there was moderate quality evidence (2 trials, 109 participants) supporting LLLT over placebo to improve pain/disability/QoL/GPE up to intermediate-term (IT). For acute radiculopathy, cervical osteoarthritis or acute neck pain, low quality evidence suggested LLLT improves ST pain/function/QoL over a placebo. For chronic myofascial neck pain (5 trials, 188 participants), evidence was conflicting; a meta-regression of heterogeneous trials suggests super-pulsed LLLT increases the chance of a successful pain outcome.Conclusions:We found diverse evidence using LLLT for neck pain. LLLT may be beneficial for chronic neck pain/function/QoL. Larger long-term dosage trials are needed.