Degenerative Changes Of Cervical Spine Research Articles

Guidelines for diagnosis and treatment of patients with neck pain – Part 1

Neck pain is one of the most prevalent musculoskeletal diseases which results in considerable pain and disability, and has a great impact on individual level, as well as on health-care system, and overall society. Causes of neck pain are different, and prevailing aetiology are mechanical reasons associated with degenerative changes of cervical spine. We are witnessing various diagnostic and therapeutic approaches for these patients. The Croatian Society for Vertebrology of the Croatian Medical Association is presenting a comprehensive narrative review and guidelines for the diagnosis and treatment of neck pain, focusing on the most prevalent causes. The guidelines are the result of consensus of experts of different background, based on the best available evidence. This part (Part 1) relates to diagnosis, while the complementary part (Part 2) relates to treatment. For the diagnostic part (Part 1) the guidelines encompass: clinical features and evaluation (including questionnaires), laboratory tests, imaging, neurophysiology tests, and minimally invasive diagnostic procedures. The management part (Part 2) includes: pharmacology treatment, physical exercise, traction, manual therapies, physical therapy modalities, orthotics, minimally invasive therapeutic interventions, surgical treatment, rehabilitation after surgical procedures, and psychiatric approach. These are the first Croatian guidelines for neck pain intended in the first place for the physicians’ professional community.

Factors Influencing Cervical Spondylosis

Background: Cervical spondylosis is a degenerative disorder of cervical spine prevalent in our population. The disease advances insidiously resulting in worsening with time. This study aims to highlight the factors influencing cervical spondylosis. Methods: The present case control study was conducted at orthopedic OPD (Out Patient Department) and Radiology department of the Patel hospital from September 2018 to February 2019 after acquiring ethical approval from Ethical Review Committee (ERC) of Bahria University Medical and Dental College and Patel Hospital. The study enrolled 88 cases suffering from cervical spondylosis based on history and clinical examination and 88 controls i.e., healthy attendants. The radiography of cervical spine was used to assess degenerative changes of cervical spine. They were asked basic history entailing age, gender, working hours, nature of job, use of computers, mobiles. The independent t-test was used for comparison between these variables, and Fischer exact test and Chi square test was employed to find association between them. Results: The study revealed a significant preponderance of females (56.8%) with shorter stature (159.14±8.88) in patients. There was a predilection for cases in outdoor workers (44.3%) and homemakers (43.2%) as well as increased working hours (73.9%). The mobile use had a significant impact (59.1%) on disease. Conclusion: Considering factors like Middle Ages, females, short stature, obesity, outdoor workers and house workers with increased working hours and use of mobiles for more than 4 hours can influence development of cervical spondylosis. One can intervene in the progression of disease by adopting healthy lifestyle to prevent it.

Magnetic resonance imaging evaluation of degenerative changes of cervical spine

Magnetic resonance imaging evaluation of degenerative changes of cervical spine

Radiofrequency neurotomy in patients with cervical pain syndrome

Introduction. Chronic pain in the neck, shoulders and upper limbs is often at degenerative changes of cervical spine joints.The purpose. Study efficacy of radiofrequency neurotomy of medial branch of spinal nerve dorsal root of cervical spine in patients with pain in the neck, shoulders and upper limbs, factors that could affect the outcome were analyzed.Materials and methods. Demographic data, types of pain location, the response to double control block, electrical stimulation parameters, the number and level of neurotomy, results of surgical treatment were studied during 12 months after surgery. Electrical stimulation intensity was from 0.3 to 0.69 V, an average — 0.45 V (to origin of pain specific for the patient).Results. In 19 (68%) among 28 patients satisfactory results were achieved, in 8 (42%) — pain disappeared completely. In 4 patients pain recrudesced in 6–12 months.Conclusions. Neurotomy of spinal nerve medial branch is an effective method for treatment of pain in the neck, shoulders and upper limbs in patients with degenerative changes in cervical spine joints.

Factors Influencing on Retro-Odontoid Soft-Tissue Thickness

A retrospective, consecutive case series. To analyze the relationship between retro-odontoid soft-tissue thickness and patients' age, sex, and degenerative changes of cervical spine and to investigate the effect these factors have on retro-odontoid soft-tissue thickness. Thickening of the soft tissue posterior to the odontoid process can form a retro-odontoid pseudotumor causing symptoms of spinal cord compression. Rheumatoid arthritis and long-term dialysis have been reported as possible causes for this. However, there have been reports of retro-odontoid pseudotumors without coexisting diseases. Findings from a total of 503 cases of cervical spine magnetic resonance images were reviewed, and retro-odontoid soft-tissue thickness was measured. The values were matched for age, sex, presence of degenerative changes, rheumatoid arthritis, and dialysis and were analyzed for significance. Retro-odontoid soft tissue thickened with age, and this was also seen in male patients and patients with degenerative changes. Significant increase in thickness was also observed in patients undergoing dialysis and further increased with prolonged dialysis. There was no significant association with presence of rheumatoid arthritis. There is association between age, sex, degenerative cervical spine changes, and dialysis with retro-odontoid soft-tissue thickness. With dialysis, retro-odontoid soft-tissue thickness increases with increasing duration. Thus, reviewing magnetic resonance image from daily practice indicates that cervical spine degeneration is associated with the development of retro-odontoid pseudotumors.

Multimodal intraoperative monitoring (MIOM) during cervical spine surgical procedures in 246 patients

A prospective study of 246 patients who received multimodal intraoperative monitoring during cervical spine surgery between March 2000 and December 2005. To determine the sensitivity and specificity of MIOM techniques used to monitor spinal cord and nerve root function during cervical spine surgery. It is appreciated that complication rate of cervical spine surgery is low, however, there is a significant risk of neurological injury. The combination of monitoring of ascending and descending pathways may provide more sensitive and specific results giving immediate feedback information and/or alert regarding any neurological changes during the operation to the surgeon. Intraoperative somatosensory spinal and cerebral evoked potentials combined with continuous EMG and motor-evoked potentials of the spinal cord and muscles were evaluated and compared with postoperative clinical neurological changes. A total of 246 consecutive patients with cervical pathologies, majority spinal stenosis due to degenerative changes of cervical spine were monitored by means of MIOM during the surgical procedure. About 232 patients presented true negative while 2 patients false negative responses. About ten patients presented true positive responses where neurological deficit after the operation was predicted and two patients presented false positive findings. The sensitivity of MIOM applied during cervical spine procedure (anterior and/or posterior) was 83.3% and specificity of 99.2%. MIOM is an effective method of monitoring the spinal cord functional integrity during cervical spine surgery and can help to reduce the risk of neurological deficit by alerting the surgeon when monitoring changes are observed.

Influence of degenerative changes of cervical spine on cerebrospinal fluid dynamics

Influence of degenerative changes of cervical spine on cerebrospinal fluid dynamics

Pattern of premature degenerative changes of the cervical spine in patients with spasmodic torticollis and the impact on the outcome of selective peripheral denervation

OBJECTIVESTo characterise the pattern of and risk factors for degenerative changes of the cervical spine in patients with spasmodic torticollis and to assess whether these changes affect outcome after selective...