Cervical Spondylosis Patients Research Articles

Features of Neck Pain and its Related Factors Among Patients With Cervical Spondylosis

Background and aims: The prevalence of cervical spondylosis is rising. The objective of this study was to figure out the various features and their related factors among cervical spondylosis patients in Dhaka, Bangladesh. Methods: A descriptive cross-sectional study was conducted enrolling 40 patients from NITOR (National Institute of Traumatology and Orthopedic Rehabilitation) in Dhaka, Bangladesh. Data were collected from the physiotherapy department of NITOR using convenient sampling technique. A structured questionnaire was used for data collection. Patients who were diagnosed with cervical spondylosis were included in this study. Data were analyzed using SPSS version 22.0. Descriptive analysis was done using frequency measures, mean and percentages. Results: Among our respondents, the majority of them were female (62.5%). Majority of the participants were in the age group of 35 to 50 years (62.5%). Many of them were urban population engaged in service or housewives. Stressful job (55%), duration of working hour >8 hours (62.5%) were the most common characteristics among patients. The main location of pain was in the shoulder (82.5%) followed by the neck (77.4%) and forearm (70%). Most patients had intermittent pain (57.5%), numbness (55%), tingling sensation (47.5%) and paresthesia (42.5%). Moderate type of pain (65%), the involvement of both upper limbs (35%) and radiating pain to shoulder (72.5%) were the most reported features by patients. No response to medication was also observed. Conclusion: Being female, middle age group, stressful occupation, location and radiation of pain to shoulder are some of the common features revealed in this study. The findings will help the practitioner to plan their treatment goals and techniques considering the characteristics of patients.

Clinical effect of grain-moxibustion combined with acupuncture in treating cervical spondylosis with neck pain

To observe the differences in the clinical effects on cervical spondylosis with neck pain between the grain-moxibustion combined with acupuncture and simple acupuncture. Eighty-eight cervical spondylosis patients with neck pain who met the inclusion criteria were randomly divided into an observation group and a control group, 44 cases in each one. The patients in the control group were treated with conventional acupuncture, and grain-moxibustion was applied on the basis treatment of the control group in the observation group. The treatment was given 3 times a week, once every other day, 10 times as one course, and followed up after 6 months. Northwick Park neck pain inventory (NPQ) and the McGill pain questionnaire (MPQ) of the two groups before and after treatment and 6 months follow-up were observed. The clinical efficacy was compared. After one course of treatment in both groups, the effective rate was 84.1% (37/44) in the control group and 86.4% (38/44) in the observation group; after 6 months follow-up, the effective rate was 79.5% (35/44) in the control group, and 81.8% (36/44) in the observation group. There was no significant difference in overall efficacy between the two groups (both P>0.05). Compared before treatment, the NPQ scores and MPQ scores were decreased at the end of one course of treatment and after 6 months follow-up in the two groups (all P<0.05). There was no significant difference in NPQ scores and MPQ scores between the two groups after one course of treatment (both P>0.05), but the NPQ scores and MPQ scores in the observation group were significantly lower than those in the control group after 6 months follow-up (both P<0.05). The immediate efficacy of grain-moxibustion combined with acupuncture for cervical spondylosis with neck pain is similar to that of simple acupuncture, however, the long-term curative effect is better.

Clinico-Demographic Characteristics of Cervical Spondylosis Patients Presented with Chest Pain

Background: The prevalence of non-cardiac chest pain is estimated to be more than 65.0% of all cases with chest pain.Objective: The objective of the present study was to see the clinic-demographics characteristics and investigational findings of cervical spondylosis patients presented with chest pain.Methodology: This cross-sectional study was carried out in the department of Physical Medicine &amp; Rehabilitation at National Institute of Cardiovascular Disease (NICVD), Dhaka, Bangladesh from July 2012 to June 2013 for a period of one year. The diagnosis was made by detailed history, clinical examination and relevant investigations.Result: In this study, female (60%) were much more sufferer especially in much younger age group (41.67%). People from urban area (68.75%) and affluent status (41.67%) were more affected; also who were in anxiety-depressed state of mind (50%) and those who worked by neck bending posture (45.83%). All patients presented with chest pain (100%) &amp; other associated symptoms like arm pain (41.67%), tingling sensation of left upper limb (22.91%), shoulder pain (25.0%) and scapular pain (16.67%). All (100%) patients had normal ECG finding. On the other hand, they (100.0%) had some finding in cervical spine X-ray; clinically the patient had painful neck movement (75.0%). A specific test for cervical radiculopathy “spurling maneuver” was positive in (22.91%).Conclusion: Through chest pain due to cervical disc disease widely reported but remains under recognized. So careful evaluation of patient for chest pain might have saved the patient for admission and various expensive invasive procedure.Journal of Current and Advance Medical Research 2018;5(2):55-59

Literature review of quality of life and influencing factors in patients of cervical spondylosis treated by ACDF

Introduction: Influence of psychosocial factors on patients of cervical spondylosis need to be calculated as they plays an important role in patient’s quality of life (QOL). As anterior cervical discectomy and fusion (ACDF) has become most common surgical approach, since 1958 introduced by Robinson and Smith in patients affected by cervical disc disease like cervical spondylosis. So we have reviewed the literature of psychosocial factors correlated with the physical conditions in patients treated with ACDF. Method and material: We have searched the literature on Pubmed, MEDLINE, EMBASE, PsycINFO, Psyc ARTICLES, Cochrane Library, Web of Science, Elisver, Google scholar, and Baidu scholar limiting results to those published in the English language without limiting year. The key search terms utilized were ACDF, quality of life, cervical spondylosis, anxiety and depression with ACDF, cervical radiculopathy, cervical myelopathies, neck pain, SF-36, HRQOL. Conclusion: On the base of previous published article men have affected more than women with age >50 years. ACDF was the most common procedure used to treat the cervical spondylosis. When it comes to psychosocial factors anxiety and depression was found to be most common influencing factor and neck pain was the physical condition accompanied to those factors. After surgery it was found a significant increase in QOL as ACDF reduces the neck pain which reflect in psychosocial factors as well by significant decrease in anxiety, depression and working ability.

Comparison between zero-profile spacer and plate with cage in the treatment of single level cervical spondylosis.

Retrospective study of 68 patients of symptomatic cervical spondylosis who were treated by anterior cervical discectomy and fusion (ACDF). The purpose of this study was to compare the clinical and radiological outcomes of patients with single level cervical spondylosis using either zero-profile spacer (group A) or anterior cervical plate and cage (group B). Clinical and radiological data of 68 patients undergoing ACDF from C3-C7 were collected retrospectively. There were 35 patients with a mean age of 54.05 years who received treatment by zero-profile implant. A total of 33 patients with a mean age of 52.09 years underwent fusion by traditional plate with cage. Group A and group B were followed up for an average of 23.68 months and 24.39 months, respectively. Age, blood loss, and operation time were assessed. The clinical outcomes were evaluated by JOA and VAS score before and after surgery. In addition, incidence of dysphagia was recorded. The Cobb angle (from C2 to C7) change was measured on the lateral cervical spine radiographs. There was no significant difference in terms of operation time and blood loss between two groups. The postoperative JOA significantly increased and the VAS decreased correspondently in both groups. The postoperative Cobb angle increased and showed statistical difference compared with preoperative Cobb angle in both groups. There was no significant difference between group A and group B in achieving clinical symptoms and radiograph improvement according to postoperative JOA, VAS and Cobb angle comparison. The incidence of postoperative dysphagia was lower in the group A than group B. Our study suggests that the application of zero-p spacer can achieve similar clinical and radiological improvement compared with traditional plate and cage. Meanwhile, zero-p is superior to plate and cage with a lower incidence of postoperative dysphagia.

Clinical effect of combined anterior and posterior approach surgery for cervical spondylotic myelopathy

&lt;p&gt;Objective: To evaluate the clinical efficacy of combined anterior and posterior approach surgery for patients with spinal type. Methods: Randomly selected from January 2013 to December 2015 in our hospital 96 cases of cervical spondylosis patients treated in our hospital from January 2013 to December 2015 , the technical way of the operation of these 96 cases of loyalty if they were randomly divided into A, B, C three groups. A group of 32 cases were treated by combined anterior and posterior approach in treatment of cervical myelopathy. B group of 32 cases patients with anterior cervical corpectomy decompression and bone graft fusion internal fixation surgery to treat cervical vertebra disease, C treatment group of 32 patients used conventional posterior decompression and fusion surgery for lateral mass screw fixation. Postoperative follow-up, the three groups of X-ray intervertebral stability and fusion, neurological function JOA score and clinical efficacy of the effective date were compared. Results: three group of patients after half a year, the JOA scores were improved, the patients of the A group after a year of score(16.3±1.83)，the scores of B and C two groups were respectively (15.7±1.15）、（15.59±1.21）, there was statistically differences between the three groups （ P ＜ 0.05). After one year’s follow-up, the bone graft and internal fixation material had no loosening, displacement and subsidence, the fusion rate of A group reached 90.6%, the fusion rate of B group was 53.1%, the fusion rate of C group was 56.25%, and the difference was statistically significant (P＜0.05）. For clinical effectiveness is divided into apparent, effective, fair, invalid. the effective rate of group A was 87.5%, and the effective rate was 50% in group B, the difference was statistically significant（P＜0.05）. Conclusion: the treatment effect of A group was better than that of B and C two groups before and after operation, and the effect was significant.&lt;/p&gt;

Regression of Anterior Disk-Osteophyte Complex Following Cervical Laminectomy and Fusion for Cervical Spondylotic Myelopathy.

A retrospective case-control study. To investigate whether posterior cervical laminectomy and fusion modifies the natural course of anterior disk-osteophyte complex in patients with multilevel cervical spondylotic myelopathy. Dorsal migration of the spinal cord is the main purported mechanism of spinal cord decompression following cervical laminectomy and fusion but other potential mechanisms have received scant attention in the literature. This study was conducted to investigate whether cervical laminectomy and fusion affects the size of anterior disk-osteophyte complex. The medical records and radiographic imaging of 44 patients who underwent cervical laminectomy and fusion for cervical spondylotic myelopathy between 2006 and 2013 were analyzed. The size of the anterior disk-osteophyte complex was measured preoperatively and postoperatively on MR images taken at an interval of >3 months apart. A control group consisted of 20 nonoperatively treated advanced cervical spondylosis patients. Patients in the control met the same inclusion and exclusion criteria and also had sequential magnetic resonance imaging (MRI) taken at an interval of >3 months apart. The nonoperative and operative groups were statistically similar in the pertinent patient demographics and characteristics including sex, age, time to second MRI, size of anterior disk-osteophyte complex on baseline MRI, mean number of levels affected, and percentage of patients with T2 signal change. As expected the mJOA scores were significantly lower in the operative versus nonoperative cohort (13.6 vs. 16.5, P<0.01). A significant decrease in the size of anterior disk osteophyte was observed in the operative group postoperatively (P<0.01). In comparison, there was no statistically significant change in the size of the anterior disk-osteophyte complex in the control group (P>0.05). The magnitude of the change in disk size between the 2 groups was statistically significant (P<0.01). The findings of this study suggest that regression of anterior disk-osteophyte complex occurs following cervical laminectomy and fusion, and likely provides another mechanism of spinal cord decompression.

Mechanoreceptors in Diseased Cervical Intervertebral Disc and Vertigo.

We collected the samples of cervical intervertebral discs from patients with vertigo to examine the distribution and types of mechanoreceptors in diseased cervical disc. The aim of this study was to determine whether mechanoreceptors are distributed more abundantly in cervical discs from patients with cervical spondylosis, and whether they are related to vertigo. Previous limited studies have found that normal cervical intervertebral discs are supplied with mechanoreceptors that have been considered responsible for proprioceptive functions. Several clinical studies have indicated that the patients with cervical spondylosis manifested significantly impaired postural control and subjective balance disturbance. We collected 77 samples of cervical discs from 62 cervical spondylosis patients without vertigo, 61 samples from 54 patients with vertigo, and 40 control samples from 8 cadaveric donors to investigate distribution of mechanoreceptors containing neurofilament (NF200) and S-100 protein immunoreactive nerve endings. The immunohistochemical investigation revealed that the most frequently encountered mechanoreceptors were the Ruffini corpuscles in all groups of cervical disc samples. They were obviously increased in the number and deeply ingrown into inner annulus fibrosus and even into nucleus pulposus in the diseased cervical discs from patients with vertigo in comparison with the discs from patients without vertigo and control discs. Only three Golgi endings were seen in the three samples from patients with vertigo. No Pacinian corpuscles were found in any samples of cervical discs. The diseased cervical discs from patients with vertigo had more abundant distribution of Ruffini corpuscles than other discs. A positive association between the increased number and ingrowth of Ruffini corpuscles in the diseased cervical disc and the incidence of vertigo in the patients with cervical spondylosis was found, which may indicate a key role of Ruffini corpuscles in the pathogenesis of vertigo of cervical origin. 1.

Neck circumference to inter-incisor gap ratio: a new predictor of difficult laryngoscopy in cervical spondylosis patients

BackgroundPreoperative airway assessment help anticipate a difficult airway. We hypothesized that a close association existed between difficult laryngoscopy and the neck circumference/inter-incisor gap ratio (RNIIG). Our aim was to determine its utility in predicting difficult laryngoscopy in cervical spondylosis patients.MethodsTwo hundred thirteen consecutive patients, aged 20–70 years, scheduled to undergo cervical spine surgery under general anesthesia, were recruited. Preoperative assessments included inter-incisor gap (IIG), thyromental distance (TMD), neck circumference (NC), NC/IIG ratio (RNIIG), NC/TMD ratio (RNTMD) and modified Mallampati test (MMT). Cormack–Lehane scales were assessed during intubation. The anesthesiologist was blinded to the airway assessments. RNIIG’s ability to predict difficult laryngoscopy was compared with that of established predictors.ResultsDifficult laryngoscopy incidence was 16.4%. Univariate analysis showed that male gender, increased age, weight, NC, RNIIG and RNTMD, decreased IIG and TMD, and MMT 3 and 4 were associated with difficult laryngoscopy. Binary multivariate logistic regression analyses identified only one factor that was independently associated with difficult laryngoscopy: RNIIG. The odds ratio and 95% confidence interval (95% CI) were 1.932 (1.504–2.482). RNIIG (≥9.5) exhibited the largest area under the curve (0.80; 95% CI 0.73–0.86) and the highest sensitivity (88.6%; 95% CI 78.1–99.1) and negative predictive value (96.6%; 95% CI 94.0–99.2), confirming its better predictive ability.ConclusionsRNIIG is a new and simple predictor with a higher level of efficacy, and could help anesthetists plan for difficult laryngoscopy management in cervical spondylosis patients.Trial registrationChiCTR-OON-16008320 (April 19th, 2016).

Traditional Chinese medicine treatment selection for straightened cervical curvature and therapeutic observation

To observe the clinical efficacy of different therapies in treating straightened cervical curvature. A hundred patients with straightened cervical curvature were randomized into 5 groups to receive corresponding treatment. The clinical efficacies and the changes of cervical curvature in the five groups were compared. Different therapies all produced certain effectiveness in treating cervical spondylosis patients. The total effective rates in the acupuncture group and tuina group were both 100%, and the rates in the traction group, oral medication group and Chinese medicinal application group were all lower than the rates in the acupuncture group and tuina group (P<0.05). It was shown that the more significant the change of cervical curvature, the more significant the clinical efficacy. Correcting the straightened cervical curvature is a way to swiftly release pain brought by cervical spondylosis; the optimization of different therapies ensures the achievement of long-term effectiveness; acupuncture and tuina are both effective in restoring the cervical curvature.

Clinical efficacy of warm needling therapy on cervical spondylosis of neck type based on the theory of "treatment both for the neck and lumbus"

To compare the difference in the short-term and long-term efficacy on cervical spondylosis of neck type between warm needling therapy in the regions of both neck and lumbus and that only in the region of neck. Eighty-one patients of cervical spondylosis of neck type were randomized into group A (41 cases) and group B (40 cases), in which 2 cases dropped out. Finally, 40 cases in the group A and 39 cases in the group B accomplished the trial. In the group A, the warm needling therapy was applied to the acupoints in the region of neck and the lumbus. Fengchi (GB 20), Tianzhu (BL 10), Neck-Bailao (EX-HN 15), Wangu (GB 12), Tianyou (TE 16) and ashi (including the tender points and code-like masses on palpation) were selected in the region of neck. Dachangshu (BL 25), Qihaishu (BL 24) and Jiaji (EX-B 2) of L5 were selected in the region of lumbus. The warm needling was applied to Fengchi (GB 20), Tianzhu (BL 10), Dachangshu (BL 25). In the group B, the warm needling therapy was applied only to the acupoints in the neck, which were same as the group A. The treatment was given once every two days, three times a week in the two groups. Separately, before treatment, 1 week after treatment, at the end of 2-week treatment and at the end of 1 month follow-up, the score of neck pain questionnaire (NPQ), the score of range of motion (ROM) in the cervical region and the score of the cervical symptoms were recorded. The efficacy at the end of treatment and in the follow-up was evaluated. Compared with those before treatment, the scores at all the observation time points were significantly improved in the two groups after treatment (all P<0.05). In the follow-up, NPQ score, ROM score and the score of cervicalsymptoms were different significantly between the two groups (all P<0.05). The results in the group A were better than those in the group B. At the end of 2-week treatment, the total effective rate was 92.5% (37/40) in the group A and was 87.2% (34/39) in the group B (P>0.05). In the follow-up, the total effective rate was 87.5% (35/40) in the group A, better than 64.1% (25/39) in the group B (P<0.05). The treatment for both neck and lumbar regions with warm needling therapy and the treatment in the local area all achieve the short-term efficacy on cervical spondylosis of neck type. For the long-term efficacy, the treatment for both neck and lumbar regions achieves the better result as compared with the routine treatment in the region of neck.

Clinical observation of cervical spondylosis of neck type with wind-cold-damp treated with four-hand-needling therapy

To compare the clinical efficacy between the four-hand-needling therapy and the routine needling therapy at neck-Jiaji (EX-B 2) in the treatment of cervical spondylosis of neck type. Eighty patients of cervical spondylosis of neck type were randomized into an observation group and a control group, 40 cases in each one. In the observation group, Sanjian (LI 3), Wailaogong (EX-UE 8), Zhongzhu (TE 3) and Houxi (SI 3) on the affected side were selected. In the control group, the neck-Jiaji (EX-B 2) on bilateral C4, C5 and C6 were selected. The treatment was given once every two days. The score of visual analogue scale (VAS) was observed before treatment, right after the first treatment, in a half of one month of treatment and in one month of treatment separately and the clinical efficacy was observed after 1-month treatment in the two groups. After treatment, VAS score was reduced as compared with that before treatment in the two groups (all P<0.05). The immediate VAS score after treatment in the observation group was reduced much more apparently as compared with that in the control group (P<0.01). The curative rate was 52.5% (21/40) in the observation group and was 32.5% (13/40) in the control group and the total effective rates were 95.0% (38/40) and 82.5% (33/40) respectively. The efficacy in the observation group was better than that in the control group (both P<0.05). The four-hand-needling therapy and routine acupuncture at neck-Jiaji (EX-B 2) all have the very good efficacy on cervical spondylosis of neck type with wind-cold-damp. The immediate efficacy of the four-hand-needling therapy is much more significant.

“Cervical Vertigo-Pathophysiology and Management: An Update”

There are many myths about cervical vertigo. Cervical vertigo is defined as vertigo from the cervical spine. In this review article, we outline the basic science and clinical evidence for cervical vertigo according to the current literature. So far, there are 4 different hypotheses explaining the vertigo of a cervical origin, including proprioceptive cervical vertigo, Barre-Lieou syndrome, rotational vertebral artery vertigo, and migraine-associated cervicogenic vertigo. Proprioceptive cervical vertigo and rotational vertebral artery vertigo have survived with time. Barre-Lieou syndrome once was discredited, but it has been resurrected recently by increased scientific evidence. Diagnosis depends mostly on patients' subjective feelings, lacking positive signs, specific laboratory examinations and clinical trials, and often relies on limited clinical experiences of clinicians. Neurological, vestibular, and psychosomatic disorders must first be excluded before the dizziness and unsteadiness in cervical pain syndromes can be attributed to a cervical origin. Treatment for cervical vertigo is challenging. Manual therapy is recommended for treatment of proprioceptive cervical vertigo. Anterior cervical surgery and percutaneous laser disc decompression are effective for the cervical spondylosis patients accompanied with Barre- Lieou syndrome. As to rotational vertebral artery vertigo, a rare entity, when the exact area of the arterial compression is identified through appropriate tests such as computed tomography angiography (CTA), magnetic resonance angiography (MRA), or digital subtraction angiography (DSA). Decompressive surgery should be the chosen treatment.

Autonomic response to valsalva maneuver in patients of cervical spondylosis

Background- Cervical spondylosis(CS) is a broad term which describes the age related chronic disc degeneration which starts in the intervertebral disc with osteophyte formation and lead to physiological degenerative cascade that contributes to biomechanical changes that result in neural and vascular compression. Autonomic balance in the body can be influenced from this compression. Aim and objectives- The aim of this study was to assess the autonomic balance in response to stress in patients of cervical spondylosis. Material and methods- Heart rate variability (HRV) was recorded during valsalva maneuver(VM) and recovery period, in two groups comprising of thirty patients with CS and thirty healthy age and sex matched controls. The results were analysed in time and frequency domains by using student t-test (significance level at p<0.05). Observations and Results- There was an inefficient autonomic response during the period of stress, with increased sympathetic tone during the recovery period. Dicussion - HRV is as a simple, non-invasive measure of the autonomic activity which analyses beat to beat variation in the heart rate and VM further improves the sensitivity of its interpretation. Conclusion - CS patients have an altered autonomic response to stress and a higher sympathetic tone than controls.

Effects of decompressive cervical surgery on blood pressure in cervical spondylosis patients with hypertension: a time series cohort study.

BackgroundPatients with cervical spondylosis myelopathy (CSM) and complicated with hypertension are often experiencing a blood pressure decrease after taking cervical decompressive surgery in clinical observations, but how this blood pressure reduction is associated with the surgery, which cut cervical sympathetic nervous, has never been rigorously assessed. Thus, the purpose of this study is to investigate the effect of cervical decompressive surgery on blood pressure among CSM patients with hypertension.Methods/DesignThe study will be a time series cohort study. Fifty eligible patients will be selected consecutively from the Peking University First Hospital. Two 24-h ambulatory blood pressure measurement (ABPM) will be taken before the surgery, apart by at least 3 days. The patients will be followed up for another two ABPMs at 1 and 3 months after the surgery.We will recruit subjects with cervical spondylosis myelopathy meeting operation indications and scheduled for receiving cervical decompressive surgery, aged 18–84 years, have a history of hypertension or office systolic blood pressure ≥140 mmHg on initial screening, and willing to participate in the study and provide informed consent. Exclusion criteria includes a history of known secondary hypertension, visual analogue scale (VAS) score ≥4, and unable to comply with study due to severe psychosis.The change in systolic ABPs over the four times will be analyzed to observe the overall pattern of the blood pressure change in relation to the surgery, but the primary analysis will be the comparison of systolic ABP between the 2nd and 3rd , 4th measurements (before and after the surgery). We will also calculate the regression-to-the-mean adjusted changes in systolic ABP as sensitivity analysis. Secondary endpoints are the changes in 24 h ABPM diastolic blood pressure, blood pressure control status, the use and dose adjustment of antihypertensive medication, and the incidence of operative complications. Primary outcome analyses will be carried out using analysis of covariance, as well as the first secondary endpoint.DiscussionThis study will inform us the important knowledge about cervical sympathetic nervous system (SNS) and blood pressure. Once confirmed, it may help to produce new method for control of hypertension, which is the leading cause of death in the world.Trial registrationThe study is registered to Clinical Trials.gov (NCT02016768).

Assessment of cranial blood flow in cervical spondylosis patients

Background: The effect of rotation of head movement on cerebral artery blood flow in normal subjects has been widely studied. Many factors effect blood flow through the vertebral artery such as rotation of head, variably sized arteries, atheroma, tortuous vertebral arteries, carotid sinus compression etc. Objective: To determine the effect of head and neck movement on the cranial blood flow in cervical spodylosis patients with reticulopathy. Material and methods: Fifty participants (23 male, 27female) with informed consent (20-70 years) participated in this study. Subjects with severe hypertension, cardiovascular, liver, kidney or other life threatening diseases were excluded. The changes in the Anterior, Middle, and Posterior cerebral arteries blood flow between the neutral (face to front) and rotated head positions (flexion and extension) was measured with Trans-cranial Doppler Method in healthy and Cervical Spondylosis with reticulopathy patients. Results: No significant differences in the afferent cerebral blood flow of the neutral and of the changed head positions in cervical spondylosis patient was found. In Cervical Spodylosis patients with reticulopathy, the mean values of cerebral blood flow were insignificantly different as compared to neutral position, however according to the data collected till now, the lowest blood inflow level was recorded during extension of the head. Flow changes were less than 10% considered to be normal. Conclusion: The flow changes in the afferent cerebral arteries of healthy subjects were insignificant. When a person has cervical spondylosis with reticulopathy, flexion and extension of head may diminish blood flow through the vertebral artery in its course through the cervical spine. Further studies and data are required to establish association. Keywords: Cervical spondylosis, Cranial blood flow, TCD

Link of sympathetic activity with cardiovascular risk in patients of cervical spondylosis

Background and Aim: Spinal cord compression as observed in cervical spondylosis patients may result in focal autonomic deficit affecting various organ systems. Hence, in the present study we aim to assess the level of sympathetic activity in patients with cervical spondylosis using cold pressor test. Methods: Cold pressor test was recorded in two groups comprising of thirty patients with cervical spondylosis and thirty healthy age and sex matched controls. Basal blood pressure (BP) was recorded in all the subjects. The BP values immediately after removal of hand from cold water and then after 5 minutes were also observed. Rate pressure product (RPP), a marker cardiovascular risk was calculated. Results: The patients with cervical spondylosis during the recovery period showed a sustained rise in BP and RPP. A rise of more than 20/10 mm of Hg, or a failure of BP to return to basal levels after 5 minutes has a positive predictive value. Conclusion: The patients with cervical spondylosis have higher sympathetic tone due to cervical compression.

Kinematic characteristics of grip force in patients with cervical spondylosis

Objective: The aim of this study was to objectively evaluate sensory disturbance in cervical spondylosis using grip force and investigate the relationship between the grip force and upper extremity function. Design: Cross-sectional study. Methods: Eleven cervical spondylosis patients with paresthesia conducted grip and lift tasks using a precision grip with the tips of the thumb and index finger on either side. The sum of the grip force used during the first four seconds was calculated and defined as the total grip force. The cutaneous pressure threshold of the fingers, the pinch power, the grip power and three subtests of the Simple Test for Evaluating Hand Function (STEF) were also assessed. Correlations between the total grip force and cutaneous pressure threshold, pinch power, grip power, and STEF subtest times were evaluated. Results: We found that the total grip force correlated with the cutaneous pressure threshold (p

Analysis of the Clinical Chinese Medicine Nursing Countermeasures of Cervical Spondylosis

&lt;strong&gt;Objective: &lt;/strong&gt;To explore the countermeasures and effects of the clinical Chinese medicine nursing of the cervical spondylosis. &lt;strong&gt;Method:&lt;/strong&gt; The cervical spondylosis patients of arthralgia type as based on syndrome differentiation of Chinese medicine science are divided into two groups. The first group, which is the control group, is made up of 42 patients who are given routine nursing. Meanwhile, the second group which is the research group, is made up of 40 patients and are given integrated nursing. On the basis of the nursing as given to the control group, the research group is also given massage, fomentation, emotional nursing, diet nursing and functional exercise. The VDS scoring of the headache, neck pain and the tingling of the upper limbs of the two groups are compared after nursing.&lt;strong&gt; Result: &lt;/strong&gt;The result of the research groups’ VDS scoring of the headache, neck pain and the tingling of the upper limbs of after nursing are obviously lower than those of the control group. After making the comparison between both groups, the data is proven to be statistically significant (&lt;em&gt;p&lt;/em&gt; &amp;lt; 0.01). The integrated nursing given to 40 patients of the research group turns out to be effective and 3 patients of the research group recover with the total effective rate being 95%, which is much higher than that of the control group (76.2%) (&lt;em&gt;p&lt;/em&gt; &amp;lt; 0.05). In addition, 38 of the patients of the research group feel satisfied with the nursing with the satisfaction rate being 95%，which is higher than that of the control group (61.9%) (&lt;em&gt;p &lt;/em&gt;&amp;lt; 0.05). &lt;strong&gt;Conculsion: &lt;/strong&gt;Integrating all kinds of nursing methods with emotional nursing and physiological nursing helps to cure cervical spondylosis and promotes recovery.

Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo

Cervical vertigo is characterized by vertigo from the cervical spine. However, whether cervical vertigo is an independent entity still remains controversial. In this narrative review, we outline the basic science and clinical evidence for cervical vertigo according to the current literature. So far, there are 4 different hypotheses explaining the vertigo of a cervical origin, including proprioceptive cervical vertigo, Barré-Lieou syndrome, rotational vertebral artery vertigo, and migraine-associated cervicogenic vertigo. Proprioceptive cervical vertigo and rotational vertebral artery vertigo have survived with time. Barré-Lieou syndrome once was discredited, but it has been resurrected recently by increased scientific evidence. Diagnosis depends mostly on patients’ subjective feelings, lacking positive signs, specific laboratory examinations and clinical trials, and often relies on limited clinical experiences of clinicians. Neurological, vestibular, and psychosomatic disorders must first be excluded before the dizziness and unsteadiness in cervical pain syndromes can be attributed to a cervical origin. Treatment for cervical vertigo is challenging. Manual therapy is recommended for treatment of proprioceptive cervical vertigo. Anterior cervical surgery and percutaneous laser disc decompression are effective for the cervical spondylosis patients accompanied with BarréLiéou syndrome. As to rotational vertebral artery vertigo, a rare entity, when the exact area of the arterial compression is identified through appropriate tests such as magnetic resonance angiography (MRA), computed tomography angiography (CTA) or digital subtraction angiography (DSA) decompressive surgery should be the chosen treatment. Key words: Cervical vertigo, dizziness, whiplash injury, neck pain, cervical spondylosis, manual therapy, vestibular rehabilitation, vertebrobasilar insufficiency