History Of Neck Pain Research Articles

Cervical Dumbbell Ganglioneuroma Causing Quadriplegia

Ganglioneuroma is a rare benign tumour that originates from the ganglion cells of the sympathetic nervous system. They are rare in cervical spine region and only 8 % of ganglioneuromas occur in the neck. The common sites of occurrence are in the posterior mediastinum, retroperitoneum and adrenal medulla, and as such, a cervical occurrence presenting with quadriplegia is a reportable event. We present a 26-year old young male with a two-year history of neck pain and progressive quadriplegia. He later became wheelchair-bound. Musculoskeletal examination revealed multiple generalized nodular skin swellings with café au lait macules. Magnetic resonance imaging showed a huge dumbbell tumour of the first two cervical vertebrae, to the right side of the spinal canal causing significant spinal cord compression. He had surgical intervention, aimed at complete tumour resection, postoperatively, power of the limbs improved to normal. Histological examination was consistent with ganglioneuroma. We present this report because the occurrence of ganglioneuroma is rare, secondly a cervical presentation is unusual and thirdly it presented as a rare cause of quadriplegia.

Spinal Cord Diffuse Midline Glioma With Histone H3 K27M Mutation in a Pediatric Patient.

Background: Diffuse midline glioma (DMG) with histone H3 K27M mutation is a recently identified entity documented in the 2016 World Health Organization (WHO) Classification of Tumors of the Central Nervous System. Spinal cord DMGs with H3 K27M-mutant are commonly reported in adults. Herein, we reported a pediatric patient with spinal cord H3 K27M-mutant DMG.Case Report: A 7-year-old girl with 1-month history of neck pain and 3-week history of progressive weakness in the right hand was presented. Spinal magnetic resonance imaging showed an intramedullary lesion with slight enhancement at the C2-7 levels. With intraoperative neuroelectrophysiological monitoring, the lesion was subtotally resected. Histopathological examination revealed a DMG with histone H3 K27M mutation corresponding to WHO grade IV. Postoperatively, the neck pain was relieved, and the upper-extremity weakness remained unchanged. Oral temozolomide was administrated for 7 months, and radiotherapy was performed for 22 courses. After an 18-month follow-up, no tumor recurrence was noted.Conclusion: Spinal cord H3 K27M-mutant DMGs are extremely rare in pediatric patients. Preoperative differential diagnosis is challenging, and surgical resection with postoperative chemoradiotherapy may be an effective treatment.

Cervical-Thoracic Epidural Hematoma Associated with a T1 Clay-Shoveler Fracture in a Pediatric Patient

This case study presents a 14-year-old boy with a 5-day history of neck pain, temporary upper extremity paresthesia, and worsening back pain after doing sled drills in football. Diagnostic imaging revealed a T1 clay-shoveler fracture and associated cervical-thoracic epidural hematoma. To the best of our knowledge, there are no previous reports of a clay-shoveler fracture that involve a spinal epidural hematoma which demonstrates an unusual version of the condition that requires surgical consultation.

A COVID-19 Patient Which is Diagnosed after Magnetic Resonance Imaging

A 40-year-old female patient without any medical history presented to the emergency department with a 3-day history of neck pain and headache. She did not show any other symptoms. Her initial laboratory tests showed slightly increased C-reactive protein (6 mg/L; normal range 0-5 mg/L) and a normal white cell count. There were

A COVID-19 Patient Which is Diagnosed after Magnetic Resonance Imaging

A 40-year-old female patient without any medical history presented to the emergency department with a 3-day history of neck pain and headache. She did not show any other symptoms. Her initial laboratory tests showed slightly increased C-reactive protein (6 mg/L; normal range 0-5 mg/L) and a normal white cell count. There were

RARE-30. A RARE CASE OF PRIMARY EWING’S SARCOMA OF THE CERVICAL SPINE

Ewing sarcoma family of tumors predominantly affect the pediatric population in the long bones of the extremities or the pelvis, and only 8% of cases arise within the spine. Primary Ewing’s sarcoma of the cervical spine is extremely rare and less than 30 cases have been reported in the literature thus far. Here we present a case of primary Ewing’s sarcoma of the cervical spine in a 28-year-old female who presented with a three-month history of neck pain and right arm radiculopathy. MRI revealed a homogeneously contrast enhancing, eccentric mass with dural tail at C2-C7. After undergoing a hemilaminectomy, histopathology confirmed extraosseous Ewing’s sarcoma with CD99 positivity. A comprehensive systemic and neuraxis work-up ruled out overt metastasis. We extrapolated data from children’s cooperative group studies and IESS-II clinical trial to formulate a three phase treatment protocol as described below. To date, patient is in remission with no evidence of any residual disease in the cervical spine. In conclusion, although Primary Ewing’s sarcoma of the cervical spine is extremely rare it should be considered a differential diagnosis in patients with neck pain and a spinal mass under the age of thirty. Less than 25% of EFT’s present with overt metastasis and almost all have subclinical metastatic disease at the time of diagnosis, therefore, a comprehensive evaluation and systemic chemotherapy is recommended. We recommend a multidisciplinary approach of surgical decompression to preserve neurological functions, followed by compressed chemotherapy regimens, reevaluation for local treatment, and adjuvant chemotherapy.

Observational study on the accuracy and speed of ultrasound guided transversus abdominis plane block with two different monitor positions

Aim of the study is to analyse the accuracy and speed of ultrasound guided transversus abdominis plane block with two different monitor positions. Prospective observational study was conducted after institutional hospital ethics committee. Twenty four male patients posted for open inguinal hernia repair posted under spinal anaesthesia were selected and divided randomly into two groups and at the end of surgery USG TAP block was given. Group I – USG monitor was kept in line, whereas in Group II – USG monitor was kept in perpendicular to the participant. Twelve anaesthetists who had performed more than 20 procedure were selected and they performed one procedure in each group. History of back pain and neck pain was elicited and any discomfort during procedure was recorded. Accuracy of USG image was recorded. Time taken for the procedure was recorded for both groups. Twelve anaesthetists were selected for this prospective study. Time taken to perform USG TAP in Group I vs Group II was (69.08 ± 8.19 s vs 80.16 ± 4.84s). Difference was statistically significant (p<0.001). Needle placement was significantly more accurate when anaesthetists had the monitor in front of them than to the side (Score was 15 vs 24). Out of 12 anaesthetists, 4 had history of neck pain previously and one was taking treatment for the same. When performed in Group I they had no discomfort but when performed in Group II, anaesthetists with positive history had discomfort during the procedure. It was concluded that the performance of USG TAP block was comfortable and more accurate and the procedure time was shorter, if the monitor was kept in line of the sight of the operator.

Severe neck pain and odynophagia\xa0secondary to\xa0acute calcific longus colli tendinitis: a case report

BackgroundAcute calcific longus colli tendinitis is a rare, noninfectious inflammatory condition caused by the deposition of calcium crystals. The condition is self-limiting, yet commonly misdiagnosed. Here we report a case of a patient with severe neck pain and odynophagia initially misdiagnosed as a retropharyngeal abscess before establishing the correct diagnosis of acute calcific longus colli tendinitis.Case presentationA 60-year-old Caucasian man presented to an outside emergency department with a 5-day history of neck pain and odynophagia. The neck pain was severe and aggravated by movement. Laboratory evaluation revealed leukocytosis and elevated C-reactive protein. Computed tomography of his neck soft tissues was initially interpreted as a retropharyngeal abscess. Antibiotic therapy with piperacillin/tazobactam was initiated, and the patient was transferred to our tertiary care center for further evaluation and treatment. On physical examination, the patient’s neck range of motion was significantly diminished, and bilateral neck tenderness was present. An otolaryngologist performed an examination with laryngoscopy, the result of which was unremarkable. A radiologist at our facility interpreted his outside magnetic resonance imaging as showing “calcification in the prevertebral muscles at C1-C2, inflammation with edema of the prevertebral muscles, and retropharyngeal space edema/effusion,” consistent with acute calcific longus colli tendinitis. His antibiotics were discontinued, and he was started on intravenous ketorolac. He had significant improvement in his neck range of motion, and his pain diminished greatly. He was discharged on a 10-day course of diclofenac (50 mg three times daily). At 1-week follow-up, the patient was doing well; he had returned to work, and his pain was well controlled.ConclusionsThis case report details the presentation, characteristic radiographic findings, and management of a patient with an extremely rare condition of neck pain and odynophagia that could be treated with nonsteroidal anti-inflammatory drugs.

An Atypical Presentation of Giant Cell Arteritis with Bilateral Choroidal Ischaemia

Background: Giant cell arteritis is an immune-mediated, medium to large vessel vasculopathy affecting individuals over 50 years of age. It can cause sudden, severe and irreversible loss of vision, most commonly from an arteritic posterior ciliary artery occlusion causing anterior ischaemic optic neuropathy. The optic nerve appearance would typically be swollen and chalky white. Visual reduction secondary to choroidal ischaemia is a much less frequent presentation, the signs of which can be more subtle in appearance, making its early recognition potentially more challenging. Case Presentation: A 51-year-old male presented to eye casualty complaining of a one-week history of neck pain, intermittent headaches and jaw claudication, associated with reduced vision in his right eye. Presenting visual acuity was hand movements and 6/5 in the right and left eyes respectively. On examination, he was noted to have a right relative afferent pupillary defect, a pale macular area in the right eye with a possible cherry red spot. There was no optic disc swelling. ESR was 34 and CRP was 46 and he was wrongly diagnosed with a non-arteritic central retinal artery occlusion. He subsequently re-presented 5 weeks later with vision loss in his left eye. Best corrected visual acuity was now 6/60 and 6/12 in the right and left eyes respectively. Dilated fundoscopy showed multiple yellow-white lesions in the posterior pole of the left eye and a retinal cotton wool spot. The right optic nerve was pale, and left was normal. A fundus fluorescein angiogram showed delayed choroidal filling and the temporal artery biopsy was suggestive of GCA. He was started on 110mgs of oral prednisolone. After 4 weeks of steroids his BCVA was 6/36 and 6/6 in the right and left eyes respectively. His neck pain, headaches and jaw claudication had all resolved and his ESR and CRP had returned to normal levels. Conclusion: Our case highlights the need for increased awareness of this uncommon presentation of this potentially blinding disease, to allow prompt and appropriate treatment. Our case is unusual in that despite a delayed diagnosis of 5 weeks, visual acuity initially improved with treatment.

Burden of neck pain among medical students in Ethiopia

BackgroundNeck pain is the major cause of morbidity and absenteeism from university lessons among medical students worldwide. Medical students are more exposed and appear to have neck pain because of their length of study to achieve their professional goals. However, up to the knowledge of the researcher, there is a scarcity of literature conducted on prevalence and associated factors of neck pain among medical students in Ethiopia. Therefore, the aim of this study was to determine the prevalence and factors associated with neck pain among medical students at Mekelle University, College of Health Sciences, Tigray, Ethiopia.MethodInstitutional based cross-sectional study was conducted from April 2018 to May 2018. A structured questionnaire adapted from the Nordic musculoskeletal questionnaire was distributed to 422 participants using a self-administered questionnaire in Mekelle University, College of Health Sciences Tigray, Ethiopia. Independent variables which had a significant association were identified using logistic regression models. Results were reported by using texts and frequency distribution tables.ResultA total of 422 participants involved in this study, with a 99.3% response rate. Previous 12 months self-reported prevalence of neck pain among medical students was found to be 49.2% with 95%CI (44.5–54%). Previous history of neck pain (AOR: 11.811, 95%CI: 5.460–25.549), physical exercise (AOR: 2.044, 95%CI: 1.233–3.387), duration of reading (AOR: 1.502, 95%CI: 0.236–2.780) and awkward posture (AOR: 3.87, 95%CI: 2.311–6.484) were factors significantly associated with neck pain.Conclusion and recommendationThe current study showed that nearly half of the study participants self-reported to have suffered neck pain in the preceding 12 months. Past history of neck pain, physical exercise, duration of reading and awkward neck posture are likely to be significantly associated neck pain among medical students in Ethiopia. Engaging in consistent physical exercise has a protective effect against neck pain. Therefore, Medical students are recommended to carry out a regular physical exercise for a minimum of twenty to thirty minutes per day.

Neck pain among undergraduate medical students in a premier institute of central India: A cross-sectional study of prevalence and associated factors.

Context:Competitive exams conducted for undergraduate and postgraduate medical courses in India are tough. The undergraduate course is additionally taxing to the students’ health. Lack of physical activity, the stress of studies, and universal adoption of different gadgets make the undergraduate medical students prone to develop musculoskeletal pain-related issues.Aims:This study aimed to evaluate the prevalence of neck pain and the associated factors including gadget use among undergraduate medical students of a premier medical college in central India.Settings and Design:All undergraduate medical students including the interns of our institute were enrolled for this cross-sectional study.Methods and Materials:A self-explanatory internet-based questionnaire prepared using Kobo Toolbox was circulated via WhatsApp and email by the class representative of each batch of students. The responses obtained were analyzed using Statistical Package for the Social Sciences (SPSS).Statistical Analysis Used:Proportions and means were calculated. Chi-square test and univariable logistic regression analysis were used.Results:Three hundred thirty-one valid responses out of 423 responses were analyzed. In total, 58.3% of 331 students suffered from neck pain within the last one year. Students in the 3rd and 4th year had 2.9 times higher odds of current neck pain in comparison to 1st-year students. History of neck pain before joining the course was associated with a higher risk of having current neck pain. Self-perceived aggravation of pain from gadget use had significantly higher odds of contributing to the current episode of neck pain.Conclusions:Neck pain is not uncommon among undergraduate medical students. History of previous neck pain including that during schooling makes a student prone for the current episode of pain. Academic stress, smartphone and laptop use tend to aggravate the pain in those who have neck pain.

Immediate Effects of Posteroanterior Cervical Mobilization on Pressure Pain Threshold and Gait Parameters in Patients with Chronic Neck Pain: A Pilot Study

Background: Mobilization and cranio-cervical flexion exercise has been reported in reducing pain from cervical part and improving its motor function; also, has been represented that alleviate of neck pain and recover of neck muscles improve the normal gait performance. However, few studies have identified the effects of mobilization and exercise on pain and gait parameters with preceding issues. Objective: To examine the effects or changes of pressure pain threshold (PPT) and gait parameters in patients with chronic neck pain. Design: Cross-Sectional Clinical Trials Methods: Twenty patients with the history of neck pain (>3 months) performed the cervical mobilization and cranio-cervical flexion exercise. Gait parameters were assessed with wireless device and collected data were transmitted to the personal computer via Bluetooth. The PPT was measured posteroanterior direction at the prone position and the mean of subsequent three PPT meas­urements was used for the final analysis. Results: Both cervical central posteroanterior mobilization (CCPAM) (p<.000) and sling-based cranio-cervical flexion exercise (SBCCFE) (p<.000) group showed a significant increase in the PPT and the gait parameters, cadence (p<.023), was significantly increased in the CCPAM group, however slightly increased in the SBCCFE group. The comparison between the CCPAM and the SBCCFE groups after treatment did not show significant differences for the score on the PPT and gait parameters. Conclusions: This study suggests that CCPAM and SBCCFE increase PPT, cadence, and gait speed.

Relatively short term test re-test reliability of Neck Disability Index by long term test re-retest reliability method of Oswestry Disability Index in healthy office workers.

Assessment of local condition specific outcome measures in combination to obtain an idea about the disability status of the whole spine is a conventional method. Oswestry Disability Index (ODI) and Neck Disability Index (NDI) are two outcome measures used together. Test re-test reliability of ODI in healthy subjects has clinical importance and the test re-test reliability of NDI may have clinical significance. The purpose of this study is to investigate the test re-test reliability of the NDI by using long-term test re-test reliability method of ODI on healthy office workers. Participants who have no chronic neck pain history were included in the study. Subjects were assessed by the Turkish-NDI (e-forms) on 1st, 2nd, 4th, 8th, 15th, 30th days. 49 (20 female, 29 male) of 106 participants (57 female, 49 male) completed the study. Kolmogorov-Smirnov and Friedman tests were used. The difference between median score of each day (χ= 9.275, p > 0.05) was neither statistically nor clinically significant. NDI has test re-test reliability in healthy subjects over a 1-month time interval and the test re-test reliability is also valid in cases where both questionnaires are used in combination in this time interval.

Monostotic fibrous dysplasia at C7 treated with vertebroplasty: a case report and review of the literature

BackgroundMonostotic fibrous dysplasia (MFD) involving the spine is rare, and the treatment options are controversial. Surgery is needed when patients suffer from persistent pain, spinal cord compression/injury, and vertebral collapse/instability. Treatment methods include biopsy/observation, corpectomy with instrumented fusion, posterior fusion, vertebroplasty (VP), curettage and bone graft, and complete removal of the vertebra with a combined anterior and posterior fusion procedure.Case presentationThe patient was a 56-year-old woman with a 2-year history of neck pain. No obvious abnormalities were detected on neurological or physical examination, and laboratory findings were all within normal limits. An imaging examination suggested a C7 vertebral bone tumor. The patient refused to continue conservative observation treatment and requested surgery. Open VP of the C7 vertebral body was carried out, and her postoperative neck pain was completely relieved. The postoperative pathological results supported the diagnosis of fibrous dysplasia, and the patient was ultimately diagnosed with MFD. At the 12-month follow-up visit, the patient reported no clinical symptoms, and no signs of tumor recurrence were detected.ConclusionVP can relieve pain while stabilizing the spine. Thus, the surgical treatment of MFD vertebral lesions by VP is a valuable option.

Cervical intradural disc herniation with Brown-Séquard syndrome: case report and literature review.

ObjectiveTo report a rare case of cervical intradural disc herniation (IDH) with Brown-Séquard syndrome and to review the related literature.MethodsPathogenesis, preoperative diagnosis, and the surgical technique are discussed, and previous literature reports are reviewed.ResultsA 44-year-old woman complained of weakness of the left upper and lower extremities and paresthesias in the right limbs after a bicycle ride 3 days earlier. She had a history of neck pain for 2 years prior. CT showed obvious ossification of the posterior longitudinal ligament (OPLL), and MRI revealed C3-7 disc herniations, with a positive “halo sign” around the herniated C4/5. We performed emergency decompression through anterior cervical corpectomy, and vertebrotomy decompression and fusion. At review 3 months after surgery, the patient’s neck pain was markedly relieved, and motor strength in the limbs had improved. At 1 year after surgery, she had recovered completely.ConclusionCervical IDH is a rare condition that may be related to the traumatic inflammatory response and OPLL. Relatively rare imaging features such as the hawk-beak sign, halo sign, Y sign, and epidural gas sign could help in preoperative diagnosis. Prompt anterior cervical decompression is the preferred treatment for this condition.

Cervical Disc Herniation Producing Acute Brown-Sequard Syndrome: A Case Report

Background: Brown-Sequard Syndrome (BSS) is a kind of rare neurological condition characterized by incomplete spinal cord lesion which results in ipsilateral loss of motor function due to corticospinal tract compression on one side of the body, and contralateral loss of pain and temperature sensitivity as a result of spinothalamic tract dysfunction on the opposite side. The possible causes of Brown-Sequard Syndrome have been frequently observed in patients with spinal traumatic injuries and extramedullary spinal tumors. However, cervical disc herniation is an exceptional cause of this syndrome. Case presentation: A 42-year-old man presented with a one-day history of neck pain and activity limitation of right arm and leg after neck massage. The Computed Tomography (CT) scan of head indicated no abnormal sign. The cervical Magnetic Resonance imaging (MRI) showed a large right-side C4/5 disc herniation which caused rightside compression of spinal cord. The patient received subtotal vertebrectomy of C5 and reconstruction with titanium mesh cage through anterior approach. The muscle strength of patient was improved the contralateral sensory disorder of pain and temperature was alleviated after the surgery. Conclusion: The case demonstrated that a prompt diagnose followed by decompression of cervical spinal cord is essential for the prognosis of the patients who diagnosed as BSS.

A rare case of Paget’s disease affecting the cervical spine

We present the case of a 75-year-old man with a rapidly progressive cervical myelopathy on a background of a 3-year history of neck pain and a severely degenerative cervical spine. The patient developed progressive myelopathy over a six-month period and suffered from worsening kyphosis. Suspicion of an underlying oncological process prompted transfer to our tertiary referral unit. Biopsy was consistent for Paget's disease, an extremely rare diagnosis of the cervical spine. Magnetic resonance imaging revealed cord compression between C4 and C6 with associated cord signal change indicative of myelopathy. A three-level corpectomy and posterior instrumented fusion was performed. There was significant blood loss (3.5l) intraoperatively, consistent with a diagnosis of Paget's disease of the bone. Cell salvage was used, as was neuromonitoring for both the anterior and posterior part of the procedure. Postoperatively, neurological function improved slightly and the patient required community neurorehabilitation to allow independent living.

WEB PLOT DIGITIZER SOFTWARE: CAN IT BE USED TO MEASURE NECK POSTURE IN CLINICAL PRACTICE?

Objective : The aim of this study was to examine the use of WPD software to evaluate FHP using digital photogrammetry method.Method: A total of 15 adults with no history of neck pain for the past 6 months were recruited for the study. Using digital photogrammetry and sagittal head tilt, craniocervical and shoulder angles (SAs) were measured using a WPD, which is an open resource of web or Windows-based software.Result: Fifteen participants aged 17–40 years (mean 24.7±6.3 years) were examined. Sagittal head tilt and craniocervical angles were 16.35°±8.33° and 47.43°±7.97°, respectively. SA was 52.28°±12.46°.Conclusion: WPD may be used to evaluate FHP in the clinical settings. However, future research is required to determine the validity and reliability of WPD among patients with neck-related musculoskeletal disorders with a larger sample.

An unusual case of dysphagia

A 51-year-old lady, with a background of an arachnoid cyst and ventriculo-peritoneal shunt in situ, presented to the Acute Medical Unit with a 2-day history of neck pain. She awoke from sleep with the pain and it persisted since. She had not been involved in any trauma, had no previous history of neck or back pain and her pain was not controlled with simple analgesia. She also complained of new odynophagia and high dysphagia, particularly to solid foods. There was no history of upper respiratory tract infection.

Large Retropharyngeal Abscess Associated with Cervical Spine Tuberculosis

AbstractThe authors report a case of a 25-year-old man who presented with the history of neck pain and weakness of the right hand of 6-month duration. He had history of fever with evening rise in temperature, loss of weight, and cough. Radiologic investigations of the cervical spine showed collapse of the C5 vertebral body and partial destruction of the C4 and C6 vertebral bodies with kyphotic deformity and a large retropharyngeal hyperintense collection. The patient underwent drainage of the abscess, and the histopathology was suggestive of tuberculosis. He was started on antitubercular treatment and doing well at follow-up.