Management Of Cervical Spondylosis Research Articles

Evaluation of comparative efficacy of Mashadi oil (Tinospora cardifolia) and Erandadi oil Ricinus communis via nasal administration in the management of cervical spondylosis: a randomized controlled trial protocol

Background- Cervical spondylosis is a disease that is caused by the vitiation of only one bodily humor (dosha) (Vataja nanatmaja). The vata bodily humor (dosa) becomes vitiated and settles in the cervical (manya), creating neck pain and stiffness, which ultimately led to cervical spondylosis. Cervical spondylosis can be examined primarily under the generalization of cervical spondylosis because both conditions have many of the same symptoms. A disorder known as cervical spondylosis, which affects the cervical vertebra, is a degenerative condition of the cervical spine. In addition to having negative effects on a person's health, the disease also significantly lowers the quality of life and daily activities. Ayurveda suggested a treatment for cervical spondylosis to avoid and control the condition. There are numerous therapies in Ayurveda, and Oil administration through the nostrils has been given a significant role in upper clavicular disease (Uurdhvajatrugata roga). Oil administration through nostril therapy has been specifically recommended by Acharya Charka for the treatment of cervical spondylosis. The purpose of certain ayurvedic approaches in the management of cervical spondylosis. Methods: - 60 patients will be split into two groups for this investigation. A tinospora cardifolia and a group of drugs (Mashadi oil) will be given to the group through the nostrils for seven days at a dose of eight drops. The same will be used for the other 30 patients, i.e., group B with Ricinus Communis and a group of drugs (Erandadi oil) administered through the nostrils. Expected result: The result will be assessed on the baseline of objective parameters, and data will be compared after the treatment.

VISHWACHI -A CASE REPORT

Vata is the prime cause of all diseases. Vishwachi is one of the vataja nanatmaja vyadhi. Being shoola pradhana vyadhi, it affects the neck and upper extremities. The clinical presentation of vishwachi resembles cervical spondylosis, a degenerative condition of the cervical spine. Hence, the Vishwachi line of treatment can be adopted in the management of cervical spondylosis. Materials and methods: Swedana, Basti karma and nasya are the samanya chikitsa for vata vyadhi. In this present case, radiating pain starting from the nape region to the right upper limb was effectively managed through Jambeera pinda sweda for five days, Kukkutanda pinda sweda for seven days, and Karpasastyadi taila nasya and oral medications were administered. Results: The patient had a significant reduction in pain and improvement in range of motion. Conclusion: Vishwachi's treatment line for cervical spondylosis yields better results.

Evaluation of comparative efficacy of Tinospora cardifolia and Ricinus communis via nasal administration in the management of cervical spondylosis: a randomized controlled trial protocol

Background- Cervical spondylosis is a disease that is caused by the vitiation of only one bodily humor (dosha) (Vataja nanatmaja). The vata bodily humor (dosa) becomes vitiated and settles in the cervical (manya), creating neck pain and stiffness, which ultimately led to cervical spondylosis. Cervical spondylosis can be examined primarily under the generalization of cervical spondylosis because both conditions have many of the same symptoms. A disorder known as cervical spondylosis, which affects the cervical vertebra, is a degenerative condition of the cervical spine. In addition to having negative effects on a person's health, the disease also significantly lowers the quality of life and daily activities. Ayurveda suggested a treatment for cervical spondylosis to avoid and control the condition. There are numerous therapies in Ayurveda, and Oil administration through the nostrils has been given a significant role in upper clavicular disease (Uurdhvajatrugata roga). Oil administration through nostril therapy has been specifically recommended by Acharya Charka for the treatment of cervical spondylosis. The purpose of certain ayurvedic approaches in the management of cervical spondylosis. Methods: - 60 patients will be split into two groups for this investigation. A tinospora cardifolia and a group of drugs (Mashadi oil) will be given to the group through the nostrils for seven days at a dose of eight drops. The same will be used for the other 30 patients, i.e., group B with Ricinus Communis and a group of drugs (Erandadi oil) administered through the nostrils. Expected result: The result will be assessed on the baseline of objective parameters, and data will be compared after the treatment.

Role of Ayurveda medicine in the management of Vishwachi Roga vis-a-vis Cervical Spondylosis

Vishwachi is purely Vataja Nanatmaja Vyadhi explained in classical treatises. It can be correlated to Cervical spondylosis. Clinical features of Cervical spondylosis are pain and stiffness in neck region, pain in upper extremities and wasting of muscles in upper extremities. X - ray findings are decreased joint space between cervical vertebrae, subchondrial sclerosis, osteophytosis and loss of cervical curvature. The disease is usually persisting for longer time. Ayurveda medicines are beneficial in this disease. Avoidance of causation factors (Nidana Parivarjana). Use of Vyadhi Pratyanika Aushadhas, Rasayana treatment, Panchakarma therapy, Pathapathya Prayoga, Yoga and Pranayama and diet therapy are advised in the management of this disease. Frequent weight lifting and heavy exercise should be avoided during treatment. Use of Vatahara, Vedana Sthapaka, Balya, Brimhana, Rasayana, Snehana, Poshaka, Swedana, nutritive, calcium supplementation, Mridu Virechana drugs are done in the management of cervical spondylosis. In this review, the role of Ayurveda medicine in the management Vishwachi Roga vis a vis Cervical spondylosis is discussed.

A multi-stage approach for high-precision measurement of cervical curvature in X-ray images

As people’s lifestyles change, cervical spondylosis affects people more often. Early diagnosis is thus crucial in the management of cervical spondylosis. Cervical curvature abnormalities may serve as an objective diagnostic standard in radiographs, commonly assessed by the Cobb angle measurement in clinical practice. The method involves the clinician marking four corners of each vertebra and then drawing lines to calculate the Cobb angle using specific rules. The whole process takes a long time and mainly relies on subjective experience. In this paper, we propose an automatic multi-stage method for measuring cervical spine Cobb angle, which is referred to as MSM-CSCA that can perform the precise measurement of cervical curvature. In Stage 1, the region of interest (ROI) of the cervical spine is carefully cropped automatically. In Stage 2, an improved CA-UNet is used to achieve detailed segmentation of the cervical spine region for the ROI region, which extracts features from the edges of the vertebrae and integrates them with the original ROI to highlight the vertebrae edges more distinctly. At Stage 3, the integrated features are input into a dual-branch landmark detection network, with segmentation and detection branches. Within this stage, the segmentation branch convolutional results are fed back into the detection branch after feature augmentation to provide a more accurate detection area. Finally, the accurately identified cervical landmarks from this network are used to calculate the Cobb angle. Experimental results show that the proposed method achieves SMAPE 15.05% and MAE 3.19 on X-ray images of the cervical spine, significantly better than the other benchmark methods. The proposed method can provide clinicians with an efficient, accurate, and reliable way for the estimation of cervical curvature.

Management of Cervical Spondylosis with Agnikarma Therapy: Case Study Article

The clinical disease known as sandhigata vata causes structural and functional disarrangement in the joints with symptoms of sandhishoola, sandhishotha, akunchana prasarana, pravrittiscavedana, and in the later stages, hanusandhigatah, sandhigata vata can be identified as a joint disease. In the context of ayurveda, some clinical conditions, such as manyastambha, manyagraha, grivastambha, and viswachi, mimic cervical spondylosis however there are no degenerative changes in these illnesses. The only condition that can be highly appropriate with cervical spondylosis is sandhigata vata. Age-related wear and tear affecting the cervical vertebrae in the neck is known as cervical spondylosis. As the disc-dehydrate and shrink, sign of osteoarthritis develops, including bony spur. agnikarma having vata kapha shamaka properties like ushna, sukshma, and ashukari guna may be helpful relives pain and muscle spasm instantly so it can be used to treat cervical spondylosis.

Effect of Balamula Ghrita Uttarabhaktika Sneha and Mashasaindhava Taila Pichu in the Management of Cervical Spondylosis - A Single Arm Prospective Open Randomized Clinical Study

In Ayurveda prevalence of Vayu mahabhuta is considered as prime factor that causes deterioration of qualities of Kapha in Greeva stana hence prescription of drugs having Vatanuloma and qualities of Prithvi and Jala mahabhuta would be very effective. In the present study humble attempt is made to evaluate the effect of Balamula Ghritam internally and combined with Mashasaindhava Tailam as external pack in arresting further degeneration. Materials and methods: 40 patients fulfilling the inclusion criteria after signing the informed consent form were selected from SJSACH [IEC N0-IEC/SJSACH/ 05/2021, CTRI N0 - CTRI/2021/07/034968]. It is a single arm prospective open randomized clinical study. Patients were administered with 10ml of Balamula Ghritam morning and night after food and Mashasaindhava Tailam as pichu (external pack) over the cervical area for 21 days with two follow ups after the completion of the trial. Result: Subjective parameters were assessed using Friedman test and Wilcoxon signed rank test and objective parameters were assessed using paired sample t test. All the parameters had highly significant results with significant p value at the end of the treatment. Conclusion: The combined effect of Balamula Ghritam and Mashasaindhava Tailam was very effective in the management of cervical spondylosis. The critical analysis of the contents of Balamula Ghritam and Mashasaindhava Tailam acts as antioxidant, removes free radicals ROS, reduces the activity of osteoclast and bone resorption by inhibiting RANKL receptor pathway. It also has anti- inflammatory, anti-arthritic, anti-analgesic effect that found to be effective in reducing the symptoms of cervical spondylosis.

Efficacy of Ayurveda formulations, Panchamrit Lauha Guggulu and Panchguna Taila in the management of Cervical Spondylosis (Greevagraha)

BACKGROUND: Cervical spondylosis (CS) is a degenerative disease of intervertebral discs with the formation of osteophytes in the cervical vertebrae. Based on the similarity in symptoms such as intermittent neck and shoulder pain, pain and stiffness radiating to the shoulder or occipital region, restricted neck movements, numbness, and weakness in arms, hands, and fingers, CS can be correlated with Greevagraha—a disease of the neck narrated in Ayurveda. In Ayurveda, the formulations Panchamrit Lauha Guggulu (PLG) and Panchguna Taila (PGT) have been narrated in treating musculoskeletal disorders. OBJECTIVE: The objective of the study was to evaluate the clinical efficacy and safety of PLG and PGT in the management of CS. MATERIALS AND METHODS: It was a prospective, single-arm, open-label clinical study. A total of 63 patients aged 30–60 years diagnosed with CS have been treated with PLG 250 mg twice a day orally with lukewarm water after food and an external application of PGT at the neck region. The total duration of the treatment was 12 weeks, with a follow-up every 2 weeks and a post treatment follow-up after 2 weeks of the treatment. The outcome measures include change in Northwick Park Neck Pain Questionnaire (NPNPQ) score, Visual Analog Scale (VAS) score for cardinal features, SF-36 (research and development [RAND]) Health Survey Score, and incidence of adverse events (if any). RESULTS: At baseline, X-ray findings of all participants (100%) had degenerative changes at different levels of cervical vertebrae; however, posttreatment X-ray findings (on the 84th day of study) showed normal X-ray findings in eight participants (5.04%). A significant reduction in the total VAS score (P < 0.001) was observed on day 84 and day 98. The mean NPNPQ score reduced significantly (P < 0.0001), and a highly significant change was observed in the SF-36 Health Survey Score (P < 0.0001). No adverse events were reported during the study period. CONCLUSIONS: PLG and PGT have shown promising outcomes in managing CS and were also safe. However, randomized control trials with adequate sample size, standard care as control, and a longer follow-up may be planned to establish the findings of this preliminary study.

Effect of compound Unani Drug in the management of cervical spondylosis (Wajaur Raqaba): A case study

Cervical spondylosis is also known as cervical osteoarthritis. It is a disorder characterised by alterations in the bones, discs, and joints of the neck. These changes are induced by the regular wear and tear of ageing, which leads to intervertebral disc degeneration and osteophyte production. The most common complaints are pain in the head, neck, and shoulders, as well as tenderness in these areas. There is also pain radiation and a reduction in cervical range of motion. Wajaur Raqaba (cervical spondylosis) is treated through Ilaj bit Tadbeer (Regional therapy), Ilaj bid Dawa (Pharmacotherapy), and Ilaj bil Yad (Surgery). The purpose of this case study was to assess the efficacy of Unani formulations Habbe Asgand and Habbe Gul-e-akh in the treatment of cervical spondylosis. A 24-year-old female patient with cervical spondylosis presented to the OPD of Ajmal Khan Tibbia College, Aligarh. Treatment was given to the patient for a period of one month. The Northwick Park Neck Pain Questionnaire (NPQ) is used for the assessment of cervical pain. As assessed by NPQ, Unani formulations were proven to be safe and effective in the management of cervical spondylosis.
 Keywords Cervical spondylosis, Wajaur Raqaba, Unani formulations, Habbe suranjan and Habbe gul-e-akh.

Effect of Surgical and Non Surgical Modalities in the Management of Cervical Spondylosis: A Prospective Interventional Study from a Tertiary Care Hospital

Introduction: Cervical spondylosis is an age-related degenerative condition of cervical spine that leads to compression of exiting nerve roots and in more severe cases compression of spinal cord, giving rise to symptoms of radiculopathy and myelopathy respectively. Till date there have been various studies on the management of cervical spondylosis, some supporting the conservative line of management whereas others favouring the surgical approach. But still there is no clear consensus about which line of management is better than the other. Aim: To assess the role of surgical and non surgical modalities in the management of cervical spondylosis using the American Spinal Injury Association (ASIA) and Visual Analog Scale (VAS) scores. Materials and Methods: The present prospective interventional study was conducted on a sample size of 100 patients presenting in Outpatient Department (OPD) of Department of General Surgery, Hamidia Hospital, Bhopal, Madhya Pradesh, India, who were diagnosed to have cervical spondylosis, between November 2018-July 2020. Patients were divided into two groups based on the mode of intervention i.e. surgical and non surgical groups. Pre and Postintervention scores were recorded according to ASIA scale (which included sensory and motor score) and VAS for pain score. The significance of change in these scores was determined by using ‘Paired t-test’. The data was analysed using XLSTAT version 2021.5.1. Results: Out of 100 patients included initially, 14 patients were lost to follow-up. The remaining 86 patients were evaluated and included in the final analysis. Out of these 86 patients, 80 were managed conservatively and six underwent surgical management. Under the conservative group, the mean preinterventional motor score was found to be 43.3±5.99 which improved to 45.7±4.78 postinterventional (p<0.001). The mean preinterventional sensory score was 105.9±6.33 which improved to 108.6±4.50 post-interventional (p<0.001) and the pain score changed from 5.17±1.14 preinterventional to 4±1.40 postinterventional (p<0.001). Similarly, in the surgical group, the mean preinterventional motor score was 31.6±4.08 which improved to 37.1±7.33 postinterventional (p=0.038). The mean sensory score changed from 90.8±16.13 preinterventional to 99.1±8.16 post-interventional (p=0.107) and the pain score improved from 7.5±1.05 preinterventional to 6.3±1.37 postinterventional (p=0.034). The p-value was found to be highly significant for the conservative group and significant for the surgical group except the sensory scores. Conclusions: Both the interventions, the non surgical and the surgical interventions were found to be effective. The conservative or the non surgical approach led to improvement in all three components (motor, sensory and pain), whereas the surgical management was found beneficial only in terms of motor and pain compartment, the sensory compartment did not show any significant benefit in present study.

A Review on Diagnosis and Management of Cervical Spondylosis

Cervical spondylosis is a term that encompasses a wide range of progressive degenerative changes that affect all components of the cervical spine (i.e., intervertebral discs, facet joints, Luschka joints, flava ligaments, and laminae). It is a natural aging process and occurs in most people after the age of five. Most people with radiographic spondylotic changes in the cervical spine remain asymptomatic, and 25% of those under 40, 50% of those over 40, and 85% of those over 60 show some evidence of degenerative changes , including changes in the environment. Uncovertebral joints, facet joints, posterior longitudinal ligament (PLL) and yellow ligament lead to narrowing of the spinal canal and intervertebral foramina. As a result, the spinal cord, spinal vasculature, and nerve roots can become compressed, leading to the three clinical syndromes that occur with cervical spondylosis: axial neck pain, cervical myelopathy, and cervical radiculopathy. Cervical spondylosis is usually diagnosed for clinical reasons only, but imaging is also required. Treatment for cervical spondylosis can be medical or surgical, depending on whether the patient has symptoms of myelopathy, radicular pain, or neck pain.

Cervical Spondylosis Management through the Spactacles of Homoeopathy

Cervical spondylosis is one of the commonly seen diseases nowadays. Neck pain, which usually arises from diseases of the cervical spine & soft tissues of the neck, is common. “SPONDYLO” is a Greek term, meaning “Vertebra” & spondylosis generally mean changes in the vertrbral joint characterized by increasing degeneration of the intervertebral disc with subsequent changes in the bones & soft tissue. The management of cervical spondylosis is very much effective with Homoeopathic medicine. This article stress upon the risk factor, pathophysiology, symptomatology, investigation in concise manner as well as emphasises how homoeopathy can manage in such cases by its holistic approach of treatment.

Cervical spondylosis: An ayurvedic review

Introduction: In this period of modernization and fast life, people undergo many unwanted practices like improper sitting posture for long time in offices, continuous work in one posture, over exertion, lack of physical exercise, excessive loads to bearing movements during travelling and sports, all these factors create undue pressure and compressive injury to the spine, that play an important role in producing disease like Cervical Spondylosis. Modern medicine has limited conservative and surgical procedures which provide only temporary symptomatic relief and many times have hazardous side effects. In Ayurveda through its sign and symptoms it can be correlated with Prishtagraha. There is need to explore the Ayurvedic perspective of cervical spondylosis by which we can cure and prevent this disease. Aim & Objective: To study the clinical manifestations, etiological factors, pathogenesis and management of cervical spondylosis through Ayurvedic perspective. Materials and Methods: For this study Ayurveda Samhitas like Charak Samhita, Sushruta Samhita etc, authentic publications, internet and modern medical literature have been reviewed. Conclusion: It is concluded that, on the basis of clinical manifestation, pathogenesis and complication cervical spondylosis can be correlated with Pristha (back of neck) Graha (stiffness or obstruction) and the Ayurvedic treatment modalities can be used as an effective management in cervical spondylosis.

A COMPARATIVE CLINICAL STUDY TO EVALUATE DIFFERENT SCHEDULES OF MARSHA NASYA WITH PRASARINI TAILA IN CERVICAL SPONDYLOSIS

Cervical spondylosis is one of the degenerative conditions of the cervical spine. It is commonly seen in old age, but nowadays it is nearly ubiquitous in young and middle-aged people. The symptoms consist of par-aesthesia and pain in the distribution of fifth to eighth cervical dermatomes, pain being felt most frequently over the shoulder, arm, scapular region, forearm and hands. In young subjects, bony outgrowth may not be evident, but loss of the cervical curvature caused by spasm of neck muscles can be taken as a suggestive sign. The presentations of signs and symptoms of both diseases have close resemblance, so Vishvachi can be correlated with Cervical Spondylosis. Improper sitting postures and continuous work create pressure and stress that cause injury to spine, which may play an important role in producing this condition. NasyaKar-ma is considered as prime line of treatment in Urdhwa Jjathrugata Vikaras and could be effective, eco-nomical as well as affordable treatment modality. Prasarini Taila is indicated in all Vata Vikaras especially in Vishvachi. Keeping these points in mind, a comparative clinical study of different schedules of Marsha Nasya with Prasarini Taila in the management of Cervical Spondylosis is taken.

A COMPARATIVE CLINICAL STUDY ON THE EFFICACY OF MARMA CHIKITSA AND STIMULATION OF MARMA POINTS USING TENS IN MANAGEMENT OF CERVICAL SPONDYLOSIS

Background: Cervical Spondylosis a degenerative disc disease, pain being the main first concern along with stiffness and decreased movements of neck. Marma chikitsa is done by employing electrical stimula-tion using TENS or adapting Varma chikitsa explained in Siddha system of medicine on Marma points ex-plained by Acharya Sushruta. Objectives: To compare the efficacy of Marma manipulation and electrical stimulation using TENS in the management of Cervical Spondylosis. Methods: 40 Subjects diagnosed with Cervical Spondylosis was divided into 2 groups of 20 each. Group A was treated with TENS and Group B was treated with Marma Chikitsa for 7 days respectively. Results: The outcome of treatment after 14 days was statistically significant based in criteria taken for study. Interpretation & Conclusion: Group A showed better effect in reducing stiffness, pain, and improves an-gle of flexion, extension, side bending, tendon reflexes, power of hand muscle and rotation of neck. Whereas Group B was effective in improving the restricted movements, tenderness and mild improvement on power of hand muscles.

Management of Cervical Spondylosis by Neurologists

Neurologists have to manage patients with cervical spondylosis, a common neurological disease in individuals over the age of 50 years. The diagnosis of cervical spondylosis requires a detailed neurological examination that takes into account cervical levels. To prevent misdiagnosis, it is important to integrate the levels of the lesions revealed by imaging with the clinical findings. Differential diagnoses for cervical spondylosis include a member of neurological diseases, including but not limited to cerebrovascular disease, amyotrophic lateral sclerosis, peripheral nerve disease, and spinal cord sarcoidosis. Though the course of the disease and the ultimate prognosis for patients with cervical spondylosis are highly variable, many patients experience a relatively benign form of the disease.

ASSESSMENT OF SPINAL CORD COMPRESSION IN PATIENTS WITH CERVICAL SPONDYLOSIS, A CLINICAL PROSPECTIVE STUDY OF 25 PATIENTS

Background: Cervical spondylosis myelopathy (CSM) is a common cause of disability in older persons. Because spondylosis is a universal finding as the patients aged. Objective: To assess the demographic and management of cervical spondylosis in a sample of Iraqi patients. Methods: This is a prospective clinical study, carried out over the period from January 2013 to December 2014, and included 25 patients with cervical spondylosis myeloradiculopathy referred for surgical intervention in Neurosurgical Department in the Al-Imamein Al-Kadhimein Medical City. General examination and full neurological assessment were performed, as well as relevant investigations, particularly; radiological assessments. All of the patients were subjected to surgery, with 17 patients (68%) were treated with laminectomy and foraminotomy, while the remaining 8 patients (32%) were treated with laminectomy only. Results: They were 14 males and 11 females, slightly affects males more than females, aged 38 to 82 years it is more common in 5th and 6th decades of life, and in rural than urban areas. Myeloradiculopathic features were the most common presenting ones with C5-C7, which were the most affected levels. General examination and full neurological assessment were performed, as well as relevant investigations, particularly; radiological assessments. All of the patients were subjected to surgery, with 17 patients (68%) were treated with laminectomy and foraminotomy, while the remaining 8 patients (32%) were treated with laminectomy only. More than half of the patients were showed slight improvement in their complaints, while significant improvement occurred in more than 28 % of patients. Despite that, 20% of patients showed no improvement in their symptomatology, however; no reported deterioration was noticed in the study. Conclusion: Myeloradiculopathic feature were the most common presenting features with C5-C7 was the most level affected. Laminectomy with foraminotomy was surgery of choice in tow third of patients, with remaining one third underwent laminectomy only. Keywords: Cervical spondylosis, spinal cord compression Citation: Jaizany AJA, Nema IS, Hassan YM. Assessment of spinal cord compression in patients with cervical spondylosis, a clinical prospective study of 25 patients. Iraqi JMS. 2018; 16(2): 152-158. doi: 10.22578/IJMS.16.2.6

The prevalence of cervical spondylosis in Muslim community with special reference to Namaz in Agra

Several studies validate the role of various supportive interventions including loosening exercises, neck exercises and yogasanas in conventional management of cervical spondylosis. The present cross-sectional study proposes that religious meditation and prayers including namaz could also be beneficial in improving the overall health and wellbeing of patients with cervical spondylosis.

Clinical evaluation of Nasya Karma in cervical spondylosis: Case series

Introduction: Cervical spondylosis is one of the most common degenerative, neurological conditions of the cervical spine by which a major part of population is affected. In today's mobile era, for higher achievements and ambitions, man is moving faster to Mars life and is more prone to degenerative disorders. Apart from age, other risk factors for cervical spondylosis include occupations that may cause more stress on neck, certain neck injuries, incorrect posture while sitting or walking, smoking, sedentary lifestyle and genetic factors. Modern therapies such as analgesics, muscle relaxants, steroids, physiotherapies, and even operative procedures are not fulfilling the patients' goal of healthy life. Materials and Methods: In Ayurveda, Degenerative disorders come under the broad umbrella of Vata Vyadhi and Nasya (Nasal Medication) is specifically indicated in Urdhvajatrugata Vikaras. Keeping this view and the increasing incidence of the disease in modern society, a study was conducted on five clinically diagnosed cases of cervical spondylosis, selected from Outpatient / Inpatient departments of Panchakarma Department. The patients were treated with Anu taila Nasya for first 3 days followed by Avartita Kshirabala Taila Nasya for the next 4 days. Results: Satisfactory relief was seen in symptoms with improved quality of life after treatment and follow up. Conclusion: Nasya Karma can be considered as an effective management of cervical spondylosis

The efficacy of ultrasound-guided extracorporeal shockwave therapy in patients with cervical spondylosis and nuchal ligament calcification

We investigated the effects of extracorporeal shockwave therapy (ESWT) on the rehabilitation of cervical spondylosis with nuchal ligament (NL) calcification under X-ray and ultrasound guidance. Sixty patients with cervical spondylosis and calcification of NL were selected and randomly assigned to three groups: A, B, and C. Patients in Group A received rehabilitation with 20 minutes of hot packs and underwent 15 minutes of intermittent cervical traction three times/week for 6 weeks. Patients in Group B received the same rehabilitation as those in Group A and ESWT (2000 impulses, 0.27 mJ/mm2) over the calcified NL guided by X-ray image. Patients in Group C received the same treatment as those in Group B, but the ESWT was guided by musculoskeletal sonography. The therapeutic effects were evaluated by: changes in range of motion (ROM) of the cervical spine including flexion, extension, lateral bending, and rotation; visual analog pain scale; and Neck Disability Index before and after treatment and at follow up 3 months later. We found a significant reduction in pain in each treated group after treatment and at follow up. However, patients in Groups B and C showed more improvements in ROM and neck pain relief after treatment and a decrease in Neck Disability Index. Furthermore, patients in Group C showed better cervical ROM at follow up than Group B. ESWT is an adjuvant treatment in the management of cervical spondylosis with calcification of NL and ultrasound-guided ESWT results in more functional improvements.