Cervical Radiculopathy Patients Research Articles

Influence of preoperative symptom duration on effectiveness of cervical disc arthroplasty in cervical spondylotic radiculopathy patients

To investigate the influence of preoperative symptom duration on effectiveness of cervical disc arthroplasty (CDA) in cervical spondylotic radiculopathy (CSR) patients. The clinical data of 90 CSR patients who underwent single-segment CDA between January 2008 and March 2020 and met the selection criteria were retrospectively analyzed. Based on preoperative symptom duration, patients were divided into an early intervention group (preoperative symptom duration <24 months) and a late intervention group (preoperative symptom duration ≥24 months). There was no significant difference in baseline data between the two groups ( P>0.05), including age, gender, body mass index, smoking status, surgical segment, preoperative neck disability index (NDI), visual analogue scale (VAS) score, cervical lordosis (CL), C 2-C 7 range of motion (ROM), disc angle (DA), disc ROM (DROM), and disc intervertebral height (DIH). The early intervention group had a slightly higher preoperative Japan Orthopedic Association (JOA) score than the late intervention group ( P<0.05). Perioperative indicators such as operation time, intraoperative blood loss, and postoperative hospital stay were recorded. The changes of JOA score, NDI, and VAS score at last follow-up compared with those before operation were used to evaluate the clinical efficacy, and the imaging evaluation of CL, C 2-C 7 ROM, DA, DROM, and DIH was performed before operation, immediately after operation, and at last follow-up. The incidence of prosthesis-related complications, including heterotopic ossification (HO), anterior bone loss (ABL), and prosthesis subsidence, was also assessed at last follow-up. Patients in both groups were followed up 24-120 months, with an average of 53.4 months. There was no significant difference in operation time, intraoperative blood loss, or follow-up duration between the groups ( P>0.05). However, the late intervention group had significantly longer postoperative hospital stay compared to the early intervention group ( P<0.05). At last follow-up, there was no significant difference in the changes of JOA score, NDI, and VAS score between the two groups before and after operation ( P>0.05). During the follow-up, there was no surgical revision in the two groups, and there was no significant difference in the incidence of HO, ABL, and prosthesis subsidence between the two groups at last follow-up ( P>0.05). Imaging evaluation showed that there was no significant difference in CL, C 2-C 7 ROM, DA, DROM, and DIH between the two groups at each time point before and after operation ( P>0.05). The intra-group comparison showed that the early intervention group could maintain the immediate postoperative CL at last follow-up, while the late intervention group had recovered to the preoperative level. Additionally, the C 2-C 7 ROM, DROM, and DA had all recovered to preoperative levels at last follow-up in both groups; meanwhile, the DIH significantly increased immediately after operation and sustained until the last follow-up. Preoperative symptom duration significantly affects the effectiveness of CDA in CSR patients. Patients with preoperative symptom duration ≥24 months have longer postoperative hospital stays and potentially poorer ability to maintain CL compared with patients with preoperative symptom duration <24 months.

Management outcomes of cervical radiculopathy with conservative treatment, anterior cervical discectomy fusion (ACDF), and anterior cervical disc replacement (ACDR)—Retrospective single center matched cohort study

Abstract Background: Degenerative cervical radiculopathy results from nerve root compression in the cervical neural foramina, often due to a herniated disc, osteophyte, or facetal/ligamentum flavum hypertrophy. Typically, 80% of patients show improvement within the initial 12 weeks through nonoperative measures, with surgical intervention considered for non-responders. This study aimed to compare clinical and radiological outcomes in cervical radiculopathy patients undergoing prolonged conservative care, anterior cervical discectomy and fusion (ACDF), or anterior cervical disc replacement (ACDR) after a 1‐year follow‐up. Materials and Methods: Our study was a retrospective single‐center study involving 780 cervical radiculopathy patients from January 2012 to December 2021. About 80.12% found relief with conservative management within 12 weeks. Remaining 155 patients were offered surgery, with 73 opting for continued conservative care, and 82 undergoing surgery (55 with ACDF and 27 with ACDR). Evaluation was done using visual analogue scale (VAS), Neck Disability Index (NDI), and radiographic parameters. Results: The mean follow‐up was 11.58 ± 6.7 months. ACDR group: Mean age 43.38 ± 8.56, VAS 7.81 ± 1.04 preoperatively, improved significantly to 2.07 ± 1.34 (P &lt; 0.05) at 1‐year follow‐up. ACDF group: Mean age 44.85 ± 10.65, VAS 8.22 ± 1.21 preoperatively, improved significantly to 2.09 ± 1.01 (P &lt; 0.05) at 1‐year follow‐up. Conservative group: Mean age 45.04 ± 11.19, VAS 7.77 ± 1.86 preoperatively, improved significantly to 2.08 ± 1.40 (P &lt; 0.05) at 1‐year follow‐up. Radiographic parameters significantly improved in all groups at 1‐year follow‐up (P &lt; 0.05). Range of motion (ROM) changes varied across groups. Miyazaki’s grading and Kim’s score showed comparable results. Conclusion: Comparable clinical and radiological outcomes were observed among conservative, ACDF, and ACDR approaches. ACDR approach demonstrated a better NDI score outcome. Neck ROM was better maintained or improved in the ACDR approach, decreased in ACDF, and remained almost similar in the conservative group.

Effects of Multi-modal Therapeutic Approach in Cervical Radiculopathy

Objective: To determine the effect of Mechanical cervical traction and Laser therapy along with isometric neck exercises in cervical radiculopathy patients. Study Design: Quasi-experimental study. Place and Duration of Study: Kannan Physiotherapy and Spine Clinic, Lahore Pakistan, from Jul to Dec 2020. Methodology: The study included cervical radiculopathy patients with symptoms for over two weeks. The diagnosis was confirmed by the orthopaedic department. The subjects were allocated to two equal groups by lottery method. Group-A Received Laser therapy with isometric neck exercises, and Group-B received mechanical traction with isometric neck exercises. The neck disability index, numeric pain rating scale and patient-specific function scale were used to collect data, which was analyzed using SPSS-22. Results: Out of the 128 patients, 64(50%) were in each of the two groups. The overall mean age was 41.95±36.50years, and 76(59.4%) participants were male. After three weeks of treatment sessions, statistically significant improvement was found in decreasing pain within group B having mechanical traction along isometric neck exercises (p&lt;0.05). Conclusion: Our study concluded that both treatment techniques, Laser therapy with isometric neck exercises and mechanical traction with isometric neck exercises, effectively decreased pain; however, mechanical traction with isometric neck exercises was superior.

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.

Effect of High-Power Laser Therapy on Pain and Electrophysiological Study in Cervical Radiculopathy Patients: A Randomized Controlled Trial

Effect of High-Power Laser Therapy on Pain and Electrophysiological Study in Cervical Radiculopathy Patients: A Randomized Controlled Trial

Characteristics of carpal tunnel syndrome in patients with cervical radiculopathy: A cross-sectional study.

Cervical radiculopathy (CR) is a group of signs and symptoms caused by cervical root dysfunction. Patients with this condition may also have carpal tunnel syndrome (CTS), which is caused by compression of the median nerve in the carpal tunnel. This coexistent condition is referred to as double crush syndrome (DCS) which is explained by proximal disruption in axoplasmic flow that may result in nerve dysfunction. Yet, the accuracy of this hypothesis remains controversial. Patients with confirmed CR according to electromyography were included in this retrospective study. However, we omitted patients with overt diabetic neuropathy, prior spinal or hand surgery and/or fractures, and rheumatoid arthritis. Patients underwent electrodiagnostic studies, and the results were used to determine CTS severity. We used Pearson's χ 2 test to assess the correlation between the severity of CTS and CR. Descriptive analysis was used to report patient characteristics and the prevalence of CTS in CR patients. We included 291 participants, 59% of whom were women. Although insignificant, DCS was observed more in women (n = 110) compared to men (n = 71). However, we found that patients with DCS (54.81 ± 13.3) were older than non-DCS patients (43.71 ± 12.94) which was statistically significant (p < 0.05). There was statistically no correlation between the severity of CR and CTS, ipsilaterlly (p > 0.05). In total, CTS was observed in 62.2% (n = 181) patients. In summary, we found a relatively high prevalence of DCS in the present study. In patients with and without DCS, gender did not seem to play a role but the growing age seemed to contribute to DCS. The severity of CTS was not related to CR severity at any cervical level, which negates a causal relation between the pre-existing CR and newly diagnosed CTS.

Evaluating the Extent of Ultrasound-Guided Cervical Selective Nerve Root Block in the Lower Cervical Spine: Evidence Based on Computed Tomography Images.

To verify the injectate dispersal patterns (IDP) and therapeutic outcome of ultrasound-guided cervical selective nerve root block (UG-SCNRB) in treating cervical radiculopathy (CR). Overall, 18 CR patients were recruited to undergo UG-SCNRB in the CT room. Following placement of the puncture needle tip between the target nerve root and posterior tubercle, 3 mL of the drug was administered per root (0.33% lidocaine 0.5 mL + Compound betamethasone injection 0.5mL + methylcobalamin injection 1mL + iohexol 1mL). Subsequently, the IDP was assessed on postintervention CT scan images. In all, 18 participants were analyzed. We injected 21 target cervical nerve roots, namely, 1 C4 nerve, 9 C5 nerves, and 11 C6 nerves. Among the IDPs on postintervention CT scan images, two IDPs were most prevalent, namely, the contrast spread into the extraforaminal spaces (Zone I, the interscalene) in 100% (21/21) of cases, and the foraminal space spread (Zone II) in 61.90% (13/21) of cases. The injectate spread into the epidural spaces (Zone III) in only 2 out of 21 cases (9.52%). The pain relief was significantly improved two hours after surgery, compared to the preoperative VAS pain scores (2 hours, 1.39±0.50 vs VAS at baseline, P<0.01). The VAS pain scores during follow-up were significantly lower than preoperation (1 weeks, 1.94±0.54 vs VAS at baseline; 2 weeks, 2.61±0.70, P<0.01 vs VAS at baseline; 4 weeks, 2.67±0.59, P<0.01 vs VAS at baseline). We verified, via CT imaging, that the UG-SCNRB drug diffusion was within safe range (the injectate mainly spread to the extraforaminal spaces), and without any serious complications, such as, intravascular drug injection, extensive diffusion of the epidural space, and general spinal anesthesia.

Evaluation of functional disability in cervical radiculopathy patients

AIM: The main aim of this study was to evaluate functional disability in patients with cervical radiculopathy. Our second aim was to compare neck disability between males and females.METHODS: The study included 35 participants of both sexes, in which 21 were female and 14 male. We have used three scales for the evaluation of neck disability: (1) Cervical radiculopathy Impact Scale (CRIS), (2) Neck Pain and Disability (NPAD) Scale, and (3) Copenhagen Neck Functional Disability (CNFD) Scale.RESULTS: The mean scores of CRIS were 14.35 ± 15.59 in males and 33.22 ± 17.58 in females. The NPAD Scale scores were 14.35 ± 15.59 in males and 33.22 ± 17.58 in females. The mean scores of the CNFD Scale were 7.92 ± 5.56 in males and 13.50 ± 5.61 in females. All three scales showed a significant difference between the scores of the two genders, indicating more disability in female patients as compared with the male patients.CONCLUSION: Our results showed 26.22% and 25.88% disability as per CRIS and Neck Pain and Disability Scale, respectively. We found mild-to-moderate disability in our subjects according to the CNFD Scale. The study concluded that females have more disability in cervical radiculopathy as compared to males.

Efficacy of Neural Tissue Mobilization Versus Cervical Mobilization Along with Manualtraction and Surged Faradic Current on Pain, Disability and Rom in Chronic Cervical Radiculopathy Patients

Background: Cervical radiculopathy (CR) caused by disc disease is a disabling condition characterizedbyradicular pain in one or both upper extremities, in combination with sensory, motor, and reflex changes in oneor several affected nerve-root distribution.. Cervical mobilization refers to low velocity, sustained or oscillatorypassive movements of varying amplitude applied at different range give by therapist to reduce pain and improvejoint mobility. Neuro-physiological effect of cervical mobilization helps in reduction of pain through gentle smallamplitude rhythmic oscillatory movement which stimulates the mechanoreceptors that inhibit the transmissionof nociceptive stimulus at the level of spinal cord or brain stem and thus pain get reduced. All this helps in thenormal functioning of the nervous tissue in the body.Methods: The study was conducted at Department of Physiotherapy, Rajeev Gandhi College, Bhopal. 30subjects meeting the inclusion criteria were recruited for the study. They were allocated randomly into twoequal groups, Group A and Group B respectively. Subjects in both the group received Surged Faradic Stimulation&amp; Manual Cervical Traction as a baseline treatment. In Group A, subjects received neural tissue mobilization inaddition while in Group B subjects received Cervical Mobilization in addition. Treatment was given for 6 day perweek for 4 week.Conclusion: The results of this study show that neural tissue mobilization and cervical mobilization, in combinationwith manual traction and pulsed faradic stimulation, are equally beneficial in reducing pain, disability, and ROM.

A retrospective comparative cohort study of the effects of neural mobilization (NM) alone and NM combined with transcranial direct current stimulation in patients with cervical radiculopathy.

Transcranial direct current stimulation (tDCS) and neural mobilization (NM) are widely used in clinical practice as two effective treatment. However, there have existed few studies of the combination of these two treatments, particularly in cervical radiculopathy (CR). To explore the value of combined tDCS and NM for the management of pain, disability, and quality of life (QoL) in patients with CR, authors designed this study. According to certain inclusion criteria, 36 subjects were selected from 224 patients with CR enrolled in Zhejiang Provincial People's Hospital between June 2021 and December 2021. Subjects were divided into two groups based on the treatment they had already received at the hospital. Patients in the combined tDCS group received tDCS and NM therapy, while patients in the NM group received NM therapy alone. Visual analog scale (VAS), Neck Disability Index (NDI), and EuroQuol-5 dimensions (EQ-5D) scores were assessed at baseline, immediately after treatment, and at the 4-week follow-up to evaluate pain, neck disability, and the QoL of patients. SPSS 22.0 software (IBM Corp., Armonk, NY, USA) is used as main tool for data analysis. A total of 36 patients were enrolled (19 in the combined tDCS group and 17 in the NM group). The baseline VAS, NDI, and EQ-5D scores in the combined tDCS group were 54.3±16.4 mm, 35.1±14.7, and 0.62±0.15, respectively, while the baseline VAS, NDI, and EQ-5D scores in the NM group were 54.0±16.5 mm, 31.8±12.8, and 0.64±0.15, respectively. There was no significant difference in baseline data between the two groups. At the 4-week post-treatment follow-up, the VAS score was significantly lower in the combined tDCS group than in the NM group (24.5±16.1 and 40.7±17.3 mm, respectively, P=0.008), and the NDI was also significantly lower in the combined tDCS group than in the NM group (16.1±11.5 vs. 26.6±17.7, P=0.045). There was no significant difference between the combined tDCS and NM groups in EQ-5D (0.75±0.15 vs. 0.69±0.09, P=0.192). Compared with NM therapy alone, combined tDCS and NM therapy may play a role in pain relief and neck disability improvement in CR patients.

P36. Multilevel posterior cervical foraminotomy associated with increased perioperative infection rates relative to anterior cervical discectomy with fusion and cervical disc arthroplasty

P36. Multilevel posterior cervical foraminotomy associated with increased perioperative infection rates relative to anterior cervical discectomy with fusion and cervical disc arthroplasty

Association of psychological factors with limb disability in patients with cervical radiculopathy: comparison with carpal tunnel syndrome

BackgroundRegarding musculoskeletal conditions, patient’s psychological distress, are shown to be associated with higher disability. Cervical radiculopathy (CR) and carpal tunnel syndrome (CTS), are two conditions caused by entrapment of cervical nerve roots and carpal median nerve, respectively. This study aims to investigate the association of psychological factors including depression, anxiety, and pain catastrophizing, with measures of upper limb patient-reported and performance-based disability, in patients with CR, and compare the obtained results with our similar study on CTS.MethodsIn a cross-sectional study, we recruited 92 patients with CR, and investigated their disability level using patient-reported questionnaires (Quick Disabilities of the Arm, Shoulder and Hand (DASH) and pain Likert Scale) and by measuring grip and pinch strength. We also assessed their psychological status with Hospital Anxiety and Depression Scale questionnaire for depression (HADS-D) and anxiety (HADS-A) and also Pain Catastrophizing Scale (PCS) tools. We performed correlational coefficient analysis between disability and psychological scores and regression analysis of dependent variables (Pain, DASH, grip and pinch scores) and independent (psychological) variables. Finally, Z observed value was calculated to compare correlational coefficients between two diseases of CTS and CR.ResultsThe results of the correlational coefficient analysis indicate that all three HADS-A, HADS-D and PCS scores correlated with DASH score (r = 0.49, 0.37, 0.38 for HADS-A, HADS-D and PCS, respectively; p < 0.001 for all three). HADS-A also significantly correlated with VAS pain score (r = 0.41, P < 0.001) and grip strength (r = − 0.25, P = 0.016). Linear regression analysis revealed that anxiety has a notable value for DASH and VAS pain scores as well as grip strength. Fisher’s r correlation coefficient to z transformation, revealed that there was no difference between two diseases of CTS and CR in terms of the resulted r coefficients from correlational coefficient analysis between disability and psychological distress.ConclusionIt is concluded that psychological disorders are associated with disability in CR patients, with anxiety also correlating with objective disability parameter of grip strength. Finally, both CTS and CR patients’ disabilities associate with anxiety, depression, and catastrophysing thinking in a similar manner.Level of evidenceLevel IV (cross-sectional study).

Comparison between electrotherapy and manual therapy in cervical radiculopathy: Literature review

Background: Cervical radiculopathy (CR) is a broad term that included any dysfunction related to the nerve root on cervical area. Most commonly affected nerve root C6- C7. Cervical radiculopathy is the condition in which patient feel pain, numbness, paraesthesia, tingling effect in cervical hand and upper extremity due to impingement of nerve in cervical area. The cause of nerve impingement is PIVD, instability, trauma, athletic changes; slip disc, cervical foraminal stenosis, and bone spur formation. A large number of Physiotherapy treatment was suggested which are feasible for CR including exercise mobilisation isometric exercise with therapeutic modalities TENS, US, IFT. This study is to discover the efficacy of TENS, IFT, US versus mobilization and isometric exercises, as an intervention for the patients having CR. Aim- -The purpose of this study was to compare manual therapy and electrotherapy in cervical radiculopathy patients. Method- We included 30 articles in this study, 15 for manual therapy and 15 for electrotherapy, based on randomised controlled trials. Manual therapy included isometric exercises, mobilisation, and physical exercises, while electrotherapy included ultrasonography and interferential current. T

What is success of treatment? Expected outcome scores in cervical radiculopathy patients were much higher than the previously reported cut-off values for success

PurposeTreatment success can be defined by asking a patient how they perceive their condition compared to prior to treatment, but it can also be defined by establishing success criteria in advance. We evaluated treatment outcome expectations in patients undergoing surgery or non-operative treatment for cervical radiculopathy.MethodsThe first 100 consecutive patients from an ongoing randomized controlled trial (NCT03674619) comparing the effectiveness of surgical and nonsurgical treatment for cervical radiculopathy were included. Patient-reported outcome measures and expected outcome and improvement were obtained before treatment. We compared these with previously published cut-off values for success. Arm pain, neck pain and headache were measured by a numeric rating scale. Neck disability index (NDI) was used to record pain-related disability. We applied Wilcoxon signed-rank test to compare the expected outcome scores for the two treatments.ResultsPatients reported mean NDI of 42.2 (95% CI 39.6–44.7) at baseline. The expected mean NDI one year after the treatment was 4 (95% CI 3.0–5.1). The expected mean reduction in NDI was 38.3 (95% CI 35.8–40.8). Calculated as a percentage change score, the patients expected a mean reduction of 91.2% (95% CI 89.2–93.2). Patient expectations were higher regarding surgical treatment for arm pain, neck pain and working ability, P < 0.001, but not for headache.ConclusionsThe expected improvement after treatment of cervical radiculopathy was much higher than the previously reported cut-off values for success. Patients with cervical radiculopathy had higher expectations to surgical treatment.

Microscopic Anterior Cervical Discectomy and Fusion Versus Posterior Percutaneous Endoscopic Cervical Keyhole Foraminotomy for Single-level Unilateral Cervical Radiculopathy: A Systematic Review and Meta-analysis.

A systematic review and meta-analysis. The objective of this study was to compare the safety of microscopic anterior cervical discectomy and fusion (MI-ACDF) and posterior percutaneous endoscopic keyhole foraminotomy (PPEKF) in patients diagnosed with single-level unilateral cervical radiculopathy. After conservative treatment, the symptoms will be relieved in about 90% of cervical radiculopathy patients. For the other one tenth of patients, surgical treatment is needed. The overall complication rate of MI-ACDF and PPEKF ranges from 0% to 25%, and the reoperation rate ranges from 0% to 20%. Electronic retrieval of studies from PubMed, Embase, and Cochrane Library was performed to identify comparative or single-arm studies on MI-ACDF and PPEKF. A total of 24 studies were included in our meta-analysis by screening according to the inclusion and exclusion criteria. After data extraction and quality assessment of the included studies, a meta-analysis was performed by using the R software. The pooled incidences of efficient rate, total complication rate, and reoperation rate were calculated. A total of 24 studies with 1345 patients (MI-ACDF: 644, PPEKF: 701) were identified. There was no significantly statistical difference in pooled patient effective rate (MI-ACDF: 94.3% vs. PPEKF: 93.3%, P =0.625), total complication rate (MI-ACDF: 7.1% vs. PPEKF: 4.7%, P =0.198), and reoperation rate (MI-ACDF: 1.8% vs. PPEKF: 1.1%, P =0.312). However, the common complications of the 2 procedures were different. The most common complications of MI-ACDF were dysphagia and vertebral body sinking, whereas the most common complication of PPEKF was nerve root palsy. Both MI-ACDF and PPEKF can provide a relatively safe and reliable treatment for single-level unilateral cervical radiculopathy. The 2 techniques are not significantly different in terms of effective rate, total complication rate, and reoperation rate.

Facet tropism: Association between cervical disc degeneration and cervical spondylotic radiculopathy in middle-aged patients

This study aimed to retrospectively explore the relationship between facet tropism (FT) and cervical disc degeneration in cervical spondylotic radiculopathy (CSR) patients on 3-dimensional views. A total of 180 middle-aged patients with single-level CSR at C4/5 who underwent cervical CT and MRI in our hospital were included. The incidence of FT (or called FT (+), defined as FT ≥ 7 degree) at C3/4, C4/5, C5/6 levels were measured and calculated by reconstructed CT images on 3-dimensional views. The grade of cervical disc degeneration at three levels was assessed by MRI images by the method of Miyazali. Univariate analysis was performed to compare their cervical disc degeneration grade and CSR incidence between two groups stratified by FT (+). Moreover, a logistic regression model was used to investigate the association between FT (+) and grade of cervical disc degeneration and incidence of CSR adjusting for age, gender, and BMI. Grade of cervical disc degeneration and incidence of CSR in axial FT (+) group were both significantly increased compared to axial FT (-) group, while sagittal and coronal FT (+) groups showed no difference. Axial FT (+) was significantly associated with the grade of cervical disc degeneration and incidence of CSR. in middle-aged patients with CSR, axial FT (+) might be the risk factor for cervical disc degeneration but not sagittal and coronal FT (+). Also, axial FT (+) was positively associated with CSR incidence. Therefore, axial FT might play a vital role in the progression of cervical disc degeneration and CSR occurrence.

Effectiveness of Maitland And Mulligan Mobilization In Cervical Radiculopathy Patients

The objective of the study is to differentiate the effectiveness of Mulligan and Maitland mobilization in cervical radiculopathy. Methods: 200 patients were selected and divided by lottery method into two groups. In one group i.e., Group A Maitland mobilization and in group B Mulligan mobilization was given. Patients were followed till 2 weeks. Results: There were 124(62%) male and 76(38%) female cases in study. The average age in group-A and group-B was 38.90 ± 6.97 years and 42.07±7.03 years, p-value 0.085. Before treatment the mean of pain in both group were calculated. So, in group-A was 7.40±1.45 and in group-B was 7.63±1.27 respectively, with insignificant difference. After treatment the mean pain in group-A was 3.40±1.73 and group-B was 2.53±1.57 respectively, P-value&lt; 0.05 with significantly much less pain in group-B. The difference of pain represents in group-A and group-B was 3.77±2.18 and 4.90±1.83 while group A shows better results with, p-value &lt; 0.05. Before treatment range of motion was restricted in all patients, while after treatment 80% of cases achieved normal range of movement in group-A while in group-B 92% cases achieved normal movement range. The improvement in both study groups was significantly higher at 2nd week of treatment, but in group B the improvement was higher when compared to group-A, p-value. Conclusion: The study concluded “Mulligan technique is much more effective than Maitland technique in terms of less pain and normal range of motion for cervical radiculopathy patients”.

Effectiveness of Maitland And Mulligan Mobilization In Cervical Radiculopathy Patients

The objective of the study is to differentiate the effectiveness of Mulligan and Maitland mobilization in cervical radiculopathy. Methods: 200 patients were selected and divided by lottery method into two groups. In one group i.e., Group A Maitland mobilization and in group B Mulligan mobilization was given. Patients were followed till 2 weeks. Results: There were 124(62%) male and 76(38%) female cases in study. The average age in group-A and group-B was 38.90 ± 6.97 years and 42.07±7.03 years, p-value 0.085. Before treatment the mean of pain in both group were calculated. So, in group-A was 7.40±1.45 and in group-B was 7.63±1.27 respectively, with insignificant difference. After treatment the mean pain in group-A was 3.40±1.73 and group-B was 2.53±1.57 respectively, P-value&lt; 0.05 with significantly much less pain in group-B. The difference of pain represents in group-A and group-B was 3.77±2.18 and 4.90±1.83 while group A shows better results with, p-value &lt; 0.05. Before treatment range of motion was restricted in all patients, while after treatment 80% of cases achieved normal range of movement in group-A while in group-B 92% cases achieved normal movement range. The improvement in both study groups was significantly higher at 2nd week of treatment, but in group B the improvement was higher when compared to group-A, p-value. Conclusion: The study concluded “Mulligan technique is much more effective than Maitland technique in terms of less pain and normal range of motion for cervical radiculopathy patients”.

Clinical and Radiological Comparisons of Percutaneous Low-Power Laser Discectomy and Low-Temperature Plasma Radiofrequency Ablation for Cervical Radiculopathy: A Prospective, Multicenter, Cohort Study

BackgroundMinimally invasive techniques, such as percutaneous low-power laser discectomy (PLLD) and low-temperature plasma radiofrequency ablation (coblation) can be applied to treat degenerative cervical radiculopathy. However, less evidence supports the superiority of distinct minimally-invasive therapy. Our study aimed to evaluate the clinical and radiological characteristics of the PLLD and coblation for cervical radiculopathy.MethodsThis was a prospective, multicenter, cohort study (ChiCTR-ONC-17010356). The modified Macnab criteria was performed to assess the clinical improvement pre- and post-surgery. To evaluate the radiological effect, the Pfirrmann grading system and disk herniation index were applied with MRI.ResultsIn this study, 28 patients were enrolled in the coblation group and 30 patients in the PLLD group. The mean good-excellent rate at 3-month follow-up was 82.1% for PLLD group, and 66.7% for coblation group, respectively (p = 0.179). The PLLD group achieved higher good-excellent rate 6 and 12 months after discharge (92.9 vs. 70.0%, p = 0.026). Radiological data revealed that PLLD but not coblation treatment achieved significant reduction of disk herniation index (p < 0.0001). Coblation treatment did not change the Pfirrmann grades of cervical radiculopathy patients (n = 18), and 7 out of 17 (41.2%) patients achieved improvement after PLLD therapy. None obvious adverse event was observed in this study.ConclusionBoth PLLD and coblation are effective and safe option for patients with cervical radiculopathy. Better long-term clinical outcomes may be potentially associated with the improvement of disk degeneration after PLLD treatment.

Quantitative sensory test findings in cervical radicular pain and their relationship with the symptoms.

This study aims to define and compare sensory phenotypes in cervical radiculopathy patients exhibiting neuropathic pain (NP) components with healthy volunteers using clinical examination and quantitative sensory test (QST) findings. Another aim of the study is to show whether symptomatic components of the pain detect questionnaire (PDQ) are correlated with the QST findings, which may help clinicians indicate patients with sensory abnormalities without the use of specialized tests. Fifty-seven participants were included in the study, including patients with NP (n=20) and healthy volunteers (n=37). After obtaining the sociodemographic and clinical data of the participants, the PDQ was performed in patients with pain followed by QST analysis in all participants. Analyses between painful and non-painful extremities yielded no differences in all groups for QST (p>0.05). Sensory thresholds were found to be higher in the NP group compared to healthy volunteers, and the pain threshold test was found to be lower (p<0.05) in the intergroup analyses. The changes described were found in both painful and non-painful limbs. Pain with slight pressure was found to be correlated with the lower heat pain threshold values (R=-0.602, p=0.005). Patients with NP were found to have lower thresholds for pain and higher sensory thresholds when compared to healthy volunteers. Moreover, pain with pressure component in PDQ was found to be associated with hyperalgesia in QST.