Spondylosis Research Articles

276 Outpatient Versus Inpatient Laminoplasty for Cervical Spondylosis: A Non-inferiority Analysis of Surgical Outcomes

INTRODUCTION: A rising trend of outpatient spinal procedures has been observed recently due to increasing evidence of lower risk of hospital-associated risks and better value-based healthcare delivery. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for patients undergoing cervical laminoplasty for spinal spondylosis. Patients with a hospital stay of more than 48 hours were excluded from the comparative analysis to increase baseline comparability between the two groups. Patients undergoing other spinal procedures during the same hospital stay were also excluded. The outcomes of interest were postoperative complications, nonroutine discharge, readmissions, and reoperations within 30 days after surgery. The non-inferiority of outpatient compared with inpatient surgery was defined as a risk difference of <10.0% at a one-sided 97.5% confidence interval. RESULTS: A total of 808 cervical laminoplasty surgeries were identified. The study cohorts consisted of 107 and 701 patients in outpatient and inpatient groups, respectively. All recorded baseline characteristics, except age (58.3 ± 10.6 vs. 61.4 ± 11.5, p=0.01), were similar between the two groups. The incidences of postoperative complications were 2.8% and 3.4% for the outpatient and inpatient groups, respectively, while the non-routine discharge rates were 6.5% and 3.5%. Both groups had a 30-day readmission rate of 3.7%. In addition, the 30-day reoperation rates were 2.8 % and 1.4% for the outpatient and inpatient groups, respectively. Noninferiority of outpatient surgery was documented at a risk difference of 10% for postoperative complications, non-routine discharge, and readmission and reoperation rates. CONCLUSIONS: Outpatient cervical laminoplasty demonstrated similar early postoperative outcomes compared to inpatient surgery. Noninferiority in surgical outcomes after surgery was documented for outpatient compared with inpatient cervical laminoplasty surgery.

1087 Large Incidence and Risk Factors Meta-analysis of Dysphagia in Over 132,000 Anterior, Posterior, and Hybrid Surgeries for Cervical Spondylosis Myelopathy

INTRODUCTION: Surgical management of Cervical Spondylotic Myelopathy (CSM) is associated with complications with devastating impacts. Dysphagia is one of these major complications with the incidence rate being not completely known in different surgical approaches. METHODS: PubMed/MEDLINE, SCOPUS, and Cochrane were systematically searched until January 2023. Rates and risk of complications were assessed. Meta-analysis of rates and risks was performed with generalized linear mixed model (GLMM) and inverse variance method, respectively, and compared between techniques. RESULTS: 1196 citations were screened and 39 studies with 60 instances of dysphagia incidence/risk factors reports from over 132,442 patients were identified. Dysphagia’s overall incidence rate was 4.98%[95% confidence interval 3.23-7.61] and was significantly different between surgery groups (Chi2 p < 0.01). It was found in 7.97% [4.95–12.57] of anterior surgeries, 1.52% [0.94–2.45] of posterior ones, and 11.25% [3.38–31.44] of hybrid techniques (statistical comparison: P < A < H). Advanced age (>65) risked dysphagia significantly (OR 1.38 [95%CI 1.11-1.71]). CONCLUSIONS: Chances of posterior surgery being complicated with dysphagia is not negligible and should be discussed with patient before surgery, especially with older adults.

Assessment of cervical spondylosis by dynamic MRI and its advantages over routine MRI

Background and objectives. Cervical spondylosis is an age-related condition that influences the various components of the spine. Attributed to its exceptional tissue contrast, magnetic resonance imaging (MRI) is the preferred diagnostic modality for assessing cervical spondylosis. Dynamic MRI examination adds diagnostic information obtained from imaging the patient in flexion and extension. Our study had the purpose of evaluating the flexion-extension MRI’s diagnostic utility. Materials and methods. 40 patients with cervical spondylosis joined our prospective cross-sectional study. The patients were examined by flexion and extension sagittal T2 weighted images (Dynamic MRI) in addition to static MRI cervical spine protocol. The study was carried out in our department and lasted for two years. Results. Total central spinal stenosis (TCSS) was considerably higher in extension in comparison to neutral MRI (Mean ± SD =6.1± 1.45 compared to 4.7 ± 1.29) (p<0.001) showing that extension raises the severity of the cervical spinal stenosis. TCSS was significantly decreased in flexion compared to neutral MRI (Mean ± SD = 3.2 ± 0.79 compared to 4.7 ± 1.29) (p<0.001) assuming flexion reduces the radiological severity of stenosis. Conclusion. Dynamic MRI is a valuable imaging modality. It provides useful information by highlighting more central spinal stenosis, particularly in the extension position, which enhances the treatment regimens for patients with cervical spondylosis.

A drug review on potency of Azhingil Vithai Thailam, Siddha Polyherbo formulation in the management of Ceganavatham

In Siddha system of medicine the diseases are categorized and concluded as 4448 diseases. Among these classification there are Vatha disease, Pitha diseases and Kabha diseases. The common Vatha disease are Thandaga Vatham(Lumbar spondylosis), Vathasthambam (Sciatica) and Cegana Vatham (Cervical Spondylosis. Cervical spondylosis is a disorder characterised by increasing degeneration of the intervertebral disc, with subsequent changes in the bones and soft tissues Symptoms are usually a manifestation of encroachment on local neural elements. The symptoms and signs appear to be related to the cause and time course of compression as well as the structures being compressed. Many formulations been indicated for the Cervical spondylosis, and one among these is Azhingil vithai Thailam. Every drug in the Azhingil vithai thailam possess the Anti- Vatha Property, hence this article provides the efficacy of Azhingil vithai Thailam on Cervical Spondylosis based on the Siddha literature and Modern science.

Effects of Shoulder Exercises with and Without Cervical Exercises on Pain and Function in the Patients with Cervical Spondylosis: Randomized Controlled Trial

Background: Cervical spondylosis is a chronic, degenerative, progressive disease of osteocartilagenous component of cervical spine that is usually age related and more common in men than in women, with a peak incidence between the ages of 40 and 60 years for both men and women.Objective: The aim of the study is to determine effects of shoulder exercises with and without cervical exercises on pain and function in patients with cervical spondylosis.Methods: Sixty eight diagnosed cervical spondylosis patients with 30-60 years of age were selected and randomly allocated in experimental and control groups, 34 in each group. The study was conducted in the physical therapy department of WAPDA hospital, Lahore. All participants were following the 6 weeks supervised exercise program, 4 sessions per week. Experimental group received shoulder exercises with cervical exercises while the control group received cervical exercises. Clinical outcomes were measured with visual analog scale for pain and neck disability index for function.Results: Analysis of final 61 patients were included, 31 in experimental and 30 in control (3 and 4 patients did not follow the study completely). Mean aged for experimental and control group was 49.39 ±7.022 and 49.23 ±6.704 respectively. Results showed that there was statically and clinically significance difference that as observed in from of reduction of pain P=0.001 and improvement of function P= 0.01Conclusion: Overall improvement was observed in both groups, results of study shows that shoulder exercises with cervical isometric exercises were more beneficial for outcomes of pain and function in experimental group. So we can conclude that shoulder exercise should be an integral part of treatment for cervical spondylosis patients.

The Efficacy of Manual Nerve Mobilization Combined with Traction Therapy in the Treatment of Nerve Root Cervical Spondylosis

Objective: This study aimed to evaluate the therapeutic effect of the manual nerve mobilization technique combined with traction therapy on nerve root cervical spondylosis and to investigate its effect on symptomatic improvement and functional recovery of patients. Methods: 101 patients diagnosed with nerve root cervical spondylosis were selected and randomly divided into two groups. The control group received conventional medication and physical therapy, while the observation group was treated with manual nerve mobilization combined with traction therapy. The manual nerve mobilization technique uses a delicate and gentle technique to reduce pain and inflammation by loosening the soft tissues around the compressed nerve roots. Traction therapy was used to relieve pressure on the cervical discs pull on the nerve roots, and restore the normal physiologic curvature of the cervical spine. All patients were assessed for pain scores and neck mobility before and after treatment. Results: At the end of the treatment, the pain scores of the patients in the observation group were significantly reduced and neck mobility was significantly improved, with a significant difference compared with the control group (P < 0.001). No serious adverse events occurred in the patients of the observation group after the completion of treatment. Conclusion: Manual nerve mobilization combined with traction therapy has good efficacy in the treatment of nerve root cervical spondylosis. This therapy can effectively reduce patients’ pain and improve neck motor function. Therefore, the promotion and application of this therapy in rehabilitation therapy will play a positive role in the recovery of patients with radiculopathy.

Cervical degenerative espondilopathy in post-menopausal women

Cervical syndromes comprise a set of clinical conditions that have pain (cervicalgia) in common, to which are added muscular, articular, neurological and even vascular manifestations, with cephalic (cervical cephalic syndrome) and brachial (cervical brachialgic syndrome) irradiations, whose The origin is degenerative spondylodiscopathy or cervical spondylosis. It is a very common entity with an incidence of 85% in people over 60 years of age and onset at an early age, with a high incidence in women. The most common etiology is degenerative: spondylo-disc-uncus-arthrosis constituting 90% of cases, the rest would be inflammatory, tumorous, septic and traumatic, being rare.

Highly Sensitive and Breathability Flexible Piezoresistive Pressure Sensor Based on Xylon

AbstractIn recent years, the prevalence of cervical spondylosis has been increasing, which is associated with unhealthy posture in daily life, flexible pressure sensors are beneficial in preventing cervical spine disorders. This work is dedicated to developing a flexible, high‐performance, and breathable device to monitor the health of the neck. Here, a flexible pressure sensor with a “sandwich” structure is presented, which incorporates patterned xylon fabric as the substrate and MXene as the sensitive layer. Furthermore, the application of silver nanowires (AgNWs) as the electrode material improves the piezoresistive performance. Combined with an internal elastic encapsulation method (IEEM), the sensor exhibits high sensitivity (1417.9 kPa−1 under pressure below 100 kPa) and a fast response time (30.77 ms). Compared with traditional flexible pressure sensors, the breathability of devices with an all‐fiber structure is nearly seven times higher, which better satisfies the monitoring requirements of long‐term wear. Finally, a wireless system is established by integrating a Bluetooth module and a terminal app. It enables monitoring and sensing of various physiological signals of the neck, as well as identification and alerting of long‐term poor posture such as prolonged neck flexion, showing a potential candidate for the applications of the next‐generation wearable device.

Novel Cervical Endoscopic Unilateral Laminoforaminotomy for Bilateral Decompression in Cervical Spondylosis Myeloradiculopathy: A Technical Note and Clinical Results.

Background: This study investigates the efficacy of the Cervical Endoscopic Unilateral Laminoforaminotomy for Bilateral Decompression (CE-ULFBD) technique in treating cervical myeloradiculopathy, primarily caused by degenerative spondylosis. Traditionally managed through multisegmental anterior cervical discectomy and fusion (ACDF) or laminoplasty combined with foraminotomy, this condition has recently experienced a promising shift towards minimally invasive approaches, particularly endoscopic spinal decompression. While empirical evidence is still emerging, these techniques show potential for effective treatment. Method: The objective was to evaluate the outcomes of CE-ULFBD in achieving single or multilevel bilateral foraminal and central decompression, emphasizing the reduction of injury to posterior cervical muscles and the associated postoperative neck soreness common in conventional procedures. This paper delineates the surgical procedures involved in CE-ULFBD and presents the clinical outcomes of nine patients diagnosed with myeloradiculopathy due to severe cervical stenosis. Result: Assessments were conducted using the Visual Analogue Scale (VAS) for neck and arm pain and the Modified Japanese Orthopaedic Association scale (mJOA) for the activity measurement of daily living. Results indicated a considerable decrease in pain levels according to the VAS, coupled with significant improvements in functional capacities as measured by the mJOA scale. Additionally, no major postoperative complications were noted during the follow-up period. Conclusion: The study concludes that CE-ULFBD is a safe and effective approach for the treatment of cervical myeloradiculopathy resulting from severe cervical stenosis, offering a viable and less invasive alternative to traditional decompressive surgeries.

Prevalence of Neck Pain in Dental Surgeons

Background: Cervical pain, or cervicalgia, is increasingly recognized as a significant occupational hazard among dental surgeons. The demands of dental practice, including prolonged static postures and repetitive motions, have been implicated in the development of musculoskeletal disorders, with a notable impact on the cervical spine. Objective: This study aimed to determine the prevalence of cervical pain among dental surgeons and identify associated risk factors, focusing on the impact of work-related postures. Methods: A cross-sectional study was conducted among 90 dental surgeons from June to December 2022, employing non-probability convenience sampling. Participants were recruited from Farooq Hospital (Westwood branch), Akhtar Saeed Medical and Dental College, and Fatima Memorial Hospital, Lahore. Inclusion criteria targeted dental surgeons aged 20 to 35 years, excluding those over 35, dental assistants, other medical doctors, and individuals with cervical spondylosis. Pain intensity was measured using the Numeric Pain Rating Scale (NPRS). Data analysis was performed using SPSS version 25, with quantitative variables presented as means, standard deviations, ranges, and histograms, and categorical variables as frequencies and percentages. Results: The study found that 83% of the participating dental surgeons experienced neck pain, attributable to faulty work postures. The age distribution of participants was primarily within the 20-25 age group (65.6%), and a significant majority were females (62.2%). Regarding pain intensity, 50% reported mild pain, 27.8% moderate pain, and 5.6% severe pain, with 16.7% reporting no pain. Conclusion: The high prevalence of cervical pain among dental surgeons underscores the critical need for ergonomic intervention and awareness in dental practice. Implementing ergonomic principles and promoting a better understanding of occupational health risks can potentially reduce the incidence of cervical pain and improve the overall well-being of dental professionals.

Effect of Intelligent Health Education Based on Health Belief Model on Patients With Kinesophobia After Surgical Treatment of Cervical Spondylosis

To explore the application effect of intelligent health education based on the health belief model on patients with postoperative kinesophobia after surgical treatment of cervical spondylosis. A prospective cohort study was conducted with patients who underwent anterior cervical discectomy, decompression, and fusion surgery with a single central nerve and spine center, and who had postoperative kinesophobia, ie, fear of movement. The patients made voluntary decisions concerning whether they would receive the intervention of intelligent health education. The patients were divided into a control group and an intelligent education group and the intervention started on the second day after the surgery. The intelligent education group received intelligent education starting from the second day after surgery through a WeChat widget that used the health belief model as the theoretical framework. The intelligent health education program was designed according to the concept of patient problems, needs, guidance, practice, and feedbacks. It incorporated four modules, including knowledge, intelligent exercise, overcoming obstacles, and sharing and interaction. It had such functions as reminders, fun exercise, shadowing exercise, monitoring, and documentation. Health education for the control group also started on the second day after surgery and was conducted by a method of brochures of pictures and text and WeChat group reminder messages. The participants were surveyed before discharge and 3 months after their surgery. The primary outcome measure compared between the two groups was the degree of kinesophobia. Secondary outcome measures included differences in adherence to functional exercise (Functional Exercise Adherence Scale), pain level (Visual Analogue Scale score), degree of cervical functional impairment (Cervical Disability Index), and quality of life (primarily assessed by the Quality of Life Short Form 12 [SF-12] scale for psychological and physiological health scores). A total of 112 patients were enrolled and 108 patients completed follow-up. Eventually, there were 53 cases in the intelligent education group and 55 cases in the control group. None of the patients experienced any sports-related injuries. There was no statistically significant difference in the primary and secondary outcome measures between the two groups at the time of discharge. At the 3-month follow-up after the surgery, the level of kinesophobia in the intelligent education group (25.72±3.90) was lower than that in the control group (29.67±6.16), and the difference between the two groups was statistically significant (P<0.05). In the intelligent education group, the degree of pain (expressed in the median [25th percentile, 75th percentile]) was lower than that of the control group (0 [0, 0] vs. 1 [1, 2], P<0.05), the functional exercise adherence was better than that of the control group (63.87±7.26 vs. 57.73±8.07, P<0.05), the psychological health was better than that of the control group (40.78±3.98 vs. 47.78±1.84, P<0.05), and the physical health was better than that of the control group (43.16±4.41 vs. 46.30±3.80, P<0.05), with all the differences being statistically significant. There was no statistically significant difference in the degree of cervical functional impairment between the two groups (1 [1, 2] vs. 3 [2, 7], P>0.05). Intelligent health education based on the health belief model can help reduce the degree of kinesophobia in patients with postoperative kinesophobia after surgical treatment of cervical spondylosis and improve patient prognosis.

Safety and efficacy of day anterior cervical discectomy and fusion procedure for degenerative cervical spondylosis: a retrospective analysis

ObjectiveOur study aimed to develop a day anterior cervical discectomy and fusion (ACDF) procedure to treat degenerative cervical spondylosis (DCS). The goal was to analyze its clinical implications, safety, and early effects to provide a better surgical option for eligible DCS patients.MethodsA retrospective analysis was performed to identify DCS patients who underwent day ACDF from September 2022 to August 2023. The operative time, intraoperative blood loss, postoperative drainage, preoperative and postoperative visual analog scale (VAS) scores, neck disability index (NDI) scores, Japanese Orthopedic Association (JOA) scores, JOA recovery rate (RR), incidence of dysphagia-related symptoms, 30-day hospital readmission rate, and incidence of other complications were recorded to evaluate early clinical outcomes. Radiography was performed to assess the location of the implants, neurological decompression, and cervical physiological curvature.ResultsAll 33 patients (23 women and 10 men) underwent successful surgery and experienced significant symptomatic and neurological improvements. Among them, 26 patients underwent one-segment ACDF, 5 underwent two-segment ACDF, and 2 underwent three-segment ACDF. The average operative time was 71.1 ± 20.2 min, intraoperative blood loss was 19.1 ± 6.2 mL, and postoperative drainage was 9.6 ± 5.8 mL. The preoperative VAS and NDI scores improved postoperatively (7.1 ± 1.2 vs. 3.1 ± 1.3 and 66.7% ± 4.8% vs. 24.1% ± 2.5%, respectively), with a significant difference (P < 0.01). Moreover, the preoperative JOA scores improved significantly postoperatively (7.7 ± 1.3 vs. 14.2 ± 1.4; P < 0.01) with an RR of 93.9% in good or excellent. Postoperative dysphagia-related symptoms occurred in one patient (3.0%). During the follow-up period, no patient was readmitted within 30 days after discharge; however, an incisional hematoma was reported in one patient on the 6th day after discharge, which was cured by pressure dressing. The postoperative radiographs revealed perfect implant positions and sufficient nerve decompression in all patients. Furthermore, the preoperative cervical physiological curvature improved significantly after the operation (14.5° ± 4.0° vs. 26.3° ± 5.4°; P < 0.01).ConclusionsDay ACDF has good safety and early clinical efficacy, and it could be an appropriate choice for eligible DCS patients.

A COMPARATIVE CLINICAL STUDY ON AGNIKARMA, NIRGUNDYADI UPANAHA, AND SHEPHALIKA KWATHA IN MANAGING GREEVA SANDHI-GATA VATA WITH RESPECT TO CERVICAL SPONDYLOSIS.

Greevasandhigata Vata is a form of Vata Vyadhi caused by the interference or entrance of vitiated Vata in Greeva Sandhi, leading to symptoms like Sandhishoola (pain in joint), Sandhishopa (sweeling in joint), Prasaran Aakunchnayo Pravariticha Savedana (restricted movement of joint) etc. Cervical Spondylosis is one of the leading disorders in older adults caused by degenerative changes in cervical spine vertebrae and causing symptoms like pain &amp; restricted joint movement, etc., in the neck, which further leads to the struggle of the patients to fulfil their daily routine work. Patients of Cervical spondylosis, are bound to choose analgesics, anti-inflammatory drugs, steroid injections and physiotherapy as conservative treatments to improve their quality of life. In the advanced stage, surgical treatments like spinal fusion, spinal decompression, etc., are the only options. However, these procedures do not fulfil the goal of patients because of the very high cost and therapeutic limitations. Even after surgery, patients have to take analgesics for longer duration. These drugs are also not free from adverse effects like gastritis, hyperacidity, nephrotoxicity, etc. Treatment modalities like Agnikarma, Nirgundyadi Upanaha and Shephalika Kwatha are the non-pharmacological and result oriented therapies, recommended in Ayurveda for such type of disease condition. These are proven to be Vatashamaka &amp; Vedanashamaka in various contexts.

The influence of anterior cervical discectomy and fusion surgery on cervical muscles and the correlation between related muscle changes and surgical efficacy

BackgroundAnterior cervical discectomy and fusion surgery (ACDF) is a common technique in treating degenerative cervical spondylosis. This study is to evaluate the changes of cervical muscles after ACDF and analyze the correlation between related muscle changes and clinical efficacy.MethodsSixty-five postoperative patients (single-level ACDF) with cervical spondylotic myelopathy from January 2013 to December 2022 were analyzed. The measured parameters include: the axial section of longus colli cross-sectional area (AxCSA), the volume of cervical longus, the ratio of long and short diameter line (RLS), the cervical extensor cross-sectional area (CESA), the vertebral body area (VBA), and the CESA/VBA. The visual analog scale (VAS), modified Japanese Orthopedic Association score (mJOA), and neck disability index (NDI) were evaluated. The changes in muscle morphology were analyzed, and the correlation analysis was conducted between morphological changes and function scores.ResultsThe postoperative AxCSA of surgical segment (3rd month, 12th month, and the last follow-up) was decreased compared to preoperative (141.62 ± 19.78), and the differences were significant (P < 0.05). The corresponding data reduced to (119.42 ± 20.08) mm2, (117.59 ± 19.69) mm2, and (117.41 ± 19.19) mm2, respectively (P < 0.05). The RLS increased, and the volume of cervical longus decreased significantly after surgery (P < 0.05). Negative correlation was found between postoperative volume of cervical longus and VAS at the 3rd month (r = − 0.412), 12th month (r = − 0.272), and last follow-up (r = − 0.391) (P < 0.05). Negative correlation existed between postoperative volume of cervical longus and NDI at the 3rd month (r = − 0.552), 12th month (r = − 0.293), and last follow-up (r = − 0.459) (P < 0.05).ConclusionThe volume of cervical longus decreased and its morphology changed after ACDF surgery. The mainly affected muscle was the cervical longus closing to the surgical segment. Negative correlation was found between the postoperative volume of cervical longus and function scores (VAS and NDI).

Observation on the Clinical Efficacy of Needle Knife Combined with Reduction Technique in the Treatment of Cervical Spondylosis

Observation on the Clinical Efficacy of Needle Knife Combined with Reduction Technique in the Treatment of Cervical Spondylosis

Efficacy of wet cupping in the pain management of cervical spondylosis – A randomized, controlled, open -label, parallel-group clinical trial

Background and objectiveCervical spondylosis is a chronic degenerative process of the cervical spine characterized by pain in neck, degenerative changes in intervertebral disc and osteophyte formation. Cervical spondylosis is translated as Wajaʻ ur Raqaba, a type of joint pain. The present study was aimed to evaluate the effect of wet cupping in the pain management of cervical spondylosis. MethodsThis Open, randomized, controlled, clinical study was conducted on 44 patients. Subjects in the test group (n = 22) received a series of three-staged wet cupping treatment, performed on 0, 7th and 14th day. Subjects in the control group (n = 22) received 12 sittings of Transcutaneous Electrical Nerve Stimulation (TENS): 6 sittings per week for two weeks. The objective findings of treatment were assessed with the help of VAS, Neck Disability Index (NDI) and Cervical range of motion. ResultsIntra group comparison in test group from baseline to 21st day were found highly significant (p < 0.001) in terms of VAS, NDI, Flexion, Extension and Left rotation score. While in Right rotation, Left rotation and Left lateral flexion score were found moderately significant (p < 0.01). Statistically significant difference was observed between two groups at 21st day in VAS scale, NDI, and Cervical range of motion score (p < 0.001). Interpretation and conclusionḤijāma Bish Sharṭ was found better in the management of pain due to cervical spondylosis than TENS. It can be concluded that Ḥijāma Bish Sharṭ may a better option for the pain management of cervical spondylosis. Clinical trial registrationThe trial was registered on clinical trial registry website (www.ctri.nic.in) bearing a CTRI Number, CTRI/2020/03/024,249.

Ayurvedic Management of Cervical Myelopathy

Cervical Myelopathy is a condition causing compression of the spinal cord at the cervical level of the spinal cord. It is mostly due to degenerative cervical spondylosis and is hence called Cervical Spondylotic Myelopathy. The spinal cord may directly experience compressive and ischemic dysfunction as a result of age-related spondylotic alterations. A 63-year-old male with complaints of gradually progressive weakness in the arms and hands along with numbness, tingling sensation, neck stiffness and pain around the neck region for the last 10 years came to the OPD of our hospital. The management offered by contemporary medicine is not satisfactory. Cervical myelopathy and Greevastambha can be co-related in this case, based on signs and symptoms. This case report demonstrates how the clinical and radiological symptoms of cervical spondylotic myelopathy were alleviated by an Ayurvedic intervention. To confirm these results and incorporate Ayurveda into conventional medicine for spinal cord injuries, more investigation and controlled trials are necessary.

Effects of acupuncture at myofascial trigger points combined with sling exercise therapy on clinical recovery and cervical spine biomechanics in patients with cervical spondylotic radiculopathy

Objective This research aimed to ascertain the effects of acupuncture at myofascial trigger points (MTrPs) in combination with sling exercise therapy (SET) on the clinical recovery and cervical spine biomechanics in patients with cervical spondylotic radiculopathy (CRS). Methods Eighty patients with CSR were divided into Group A and Group B. Group A was treated with acupuncture at MTrPs, and Group B was treated with acupuncture at MTrPs combined with SET. The cervical spine function, pain level, cervical spine biomechanics and the occurrence of complications were compared between the two groups before and after treatment. Results After treatment, the Japanese Orthopaedic Association scores, Clinical Assessment Scale for Cervical Spondylosis scores, cervical forward flexion angle, posterior extension angle, left lateral flexion angle, right lateral flexion angle, left lateral rotation angle, and right lateral rotation angle of the Group B were raised, and the Neck Disability index, Visual Analogue Scale scores, and Neck Pain Questionnaire scores were reduced versus those of the Group A. The difference in complication rates between the two groups was not of statistical significance. Conclusion Acupuncture at MTrPs combined with SET promotes functional recovery of the cervical spine, reduces pain, and improves cervical spine biomechanics in patients with CRS.

Emergency Management of Vastivyapath with Oral Administration of Kamadudharasa

Vasti is one among the most widely used therapeutic procedures in Ayurveda especially in neurological and degenerative diseases. Proper guidelines for Panchakarma procedures are laid out in the classics for better outcome and minimal complications. Till date, the guidelines hold value and current practices revolve around the same. Though there are plenty of insights into the benefits of Vasti, minimal information is available about the complications and management. This case report is an attempt to understand how the administration of a Kashaya vasti in a known case of lumbar spondylosis resulted in complication and managed with oral administration of Kamadudharasa. A 64 year old male patient with primary complaint of low back ache developed pain and burning sensation per abdomen after giving Erandamooladi niruhavasti. He went to a state of confusion. Initial management was done using Dhanvantaram gutika, which failed to revive the patient. A single dose of Kamadudha rasa was administered sublingually following which he regained consciousness. This was followed by a reduction in the burning sensation and the patient felt better. On detailed analysis, it was found that the patient had a history of gastritis and was on medication for the same. The Teekshna guna of Erandamuladi vasti probably worsened the state of Pitta in his Koshta and lead to the complications such as Sula, Daha and Moha. A detailed understanding of the selection of the right type of Niruha vasti is necessary for better outcomes. This brings our attention to the importance of Sameekshya bhava and how it plays an important role in deciding the outcome of Panchakarma procedures. Failure to do so may result in Vyapath/complications.

A low‐cost method for testing and analyzing the cervical range of motion

AbstractMeasurement of the cervical range of motion (CROM) is significant for early diagnosis of cervical spondylosis and determination of the severity of the disease. Aiming at the problem of convenient and continuous measurement of CROM and the reduction of the impact of data fluctuations, this paper proposes a low‐cost method for testing and analyzing CROM. This paper analyzes the correspondence between smartphone orientation sensor angle and CROM, obtains smartphone orientation sensing data, and uses the extreme‐point symmetric mode decomposition method by calculating the energy of the difference value to extract the adaptive global mean curve of the CROM data, and calculates the cervical ROM. The statistical analysis of the CROM test results is carried out. Results show that the method proposed can obtain the CROM including flexion and extension, lateral flexion, and rotation in a single measurement, which has the advantages of continuous measurement and low cost.